Sample records for eos orthopaedic imaging

  1. Calibration of EOS multispectral imaging sensors and solar irradiance variability (United States)

    Mecherikunnel, Ann


    Earth Observation System (EOS) optical multispectral imaging sensors provide images of the earth at various spectral and spatial resolutions, in the visible (VIS) and infrared (IR) regions of the solar spectrum. Accurate knowledge of extraterrestrial solar spectral irradiance and its variations with time, are needed to trace sensor calibration in space, and for the development of terrestrial atmospheric models needed in data validation. A brief review of the extraterrestrial solar VIS/IR spectral irradiance available in the literature will be reviewed, and the need to develop an extraterrestrial solar spectral irradiance for the EOS studies will be pointed out. The solar calibration of the Earth Radiation Budget Experiments (ERBE), earth-viewing sensors will be discussed. Observed variations in the solar constant (solar irradiance, at the mean sun-earth distance of one astronomical unit, integrated over all wavelengths), and solar spectral irradiance with solar activity and its implications for EOS studies also will be discussed.

  2. Seasonal spectral dynamics and carbon fluxes at core EOS sites using EO-1 Hyperion images (United States)

    Lagomasino, D.; Campbell, P.; Price, R. M.


    Fluxes of water and carbon into the atmosphere are critical components in order to monitor and predict climate change. Spatial heterogeneity and seasonal changes in vegetation contribute to ambiguities in regional and global CO2 and water cycle dynamics. Satellite remote sensing is essential for monitoring the spatial and temporal dynamics of various vegetation types for the purposes of determining carbon and water fluxes. Satellite data from the EO-1 Hyperion sensor was acquired for five Earth Observing Satellite (EOS) sites, Mongu (Zambia, Africa), Konza Prairie (Kansas, USA), Duke Forest (North Carolina, USA), Barrow (Alaska, USA) and Sevilleta (New Mexico, USA). Each EOS site represented a distinct vegetative ecosystem type; hardwood forest, grassland, evergreen forest, lichens, and shrubland/grassland respectively. Satellite data was atmospherically corrected using the Atmosphere CORrection Now (ACORN) model and subsequently, the spectral reflectance data was extracted in the vicinity of existing flux towers. The EO-1 Hyperion sensor proved advantageous because of its high and continuous spectral resolution (10 nm intervals from 355 to 2578 nm wavelengths). The high spectral resolution allowed us calculate biophysical indices based on specific wavelengths in the electromagnetic spectrum that are associated with alterations in foliar chemistry and plant membrane structure (i.e., vegetation stress) brought upon by many environmental factors. Previous studies have focused on relationships within a specific site or vegetation community. This study however, incorporated many sites with different vegetation types and various geographic locations throughout the world. Monitoring the fluctuations in vegetation stress with contemporaneous environmental conditions and carbon flux measurements from each site will provide better insight into water and carbon flux dynamics in many different biomes. Noticeable spectral signatures were identified based on site specific

  3. The EOS 2D/3D X-ray imaging system: a cost-effectiveness analysis quantifying the health benefits from reduced radiation exposure. (United States)

    Faria, Rita; McKenna, Claire; Wade, Ros; Yang, Huiqin; Woolacott, Nerys; Sculpher, Mark


    To evaluate the cost-effectiveness of the EOS(®) 2D/3D X-ray imaging system compared with standard X-ray for the diagnosis and monitoring of orthopaedic conditions. A decision analytic model was developed to quantify the long-term costs and health outcomes, expressed as quality-adjusted life years (QALYs) from the UK health service perspective. Input parameters were obtained from medical literature, previously developed cancer models and expert advice. Threshold analysis was used to quantify the additional health benefits required, over and above those associated with radiation-induced cancers, for EOS(®) to be considered cost-effective. Standard X-ray is associated with a maximum health loss of 0.001 QALYs, approximately 0.4 of a day in full health, while the loss with EOS(®) is a maximum of 0.00015 QALYs, or 0.05 of a day in full health. On a per patient basis, EOS(®) is more expensive than standard X-ray by between £10.66 and £224.74 depending on the assumptions employed. The results suggest that EOS(®) is not cost-effective for any indication. Health benefits over and above those obtained from lower radiation would need to double for EOS to be considered cost-effective. No evidence currently exists on whether there are health benefits associated with imaging improvements from the use of EOS(®). The health benefits from radiation dose reductions are very small. Unless EOS(®) can generate additional health benefits as a consequence of the nature and quality of the image, comparative patient throughput with X-ray will be the major determinant of cost-effectiveness. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

  4. 'Ready-access' CT imaging for an orthopaedic trauma clinic.

    LENUS (Irish Health Repository)

    Cawley, D


    \\'Ready-Access\\' to CT imaging facilities in Orthopaedic Trauma Clinics is not a standard facility. This facility has been available at the regional trauma unit, in Merlin Park Hospital, Galway for the past four years. We reviewed the use of this facility over a 2-year period when 100 patients had CT scans as part of their trauma clinic assessment. The rate of CT scan per clinic was 0.6. The mean waiting time for a CT scan was 30 minutes. 20 (20%) new fractures were confirmed, 33 (33%) fractures were out-ruled, 25 (25%) fractures demonstrated additional information and 8 (8%) had additional fractures. 20 (20%) patients were discharged and 12 (12%) patients were admitted as a result of the CT scan. It adds little time and cost to CT scanning lists.

  5. Imaging from an orthopaedic point of view. What the orthopaedic surgeon expects from the radiologist?

    NARCIS (Netherlands)

    van Dijk, C. Niek; de Leeuw, Peter A. J.


    The paradigm of coping with sometimes gross pathology, while having some small and at first sight insignificant lesions demands for accurate radiological detection and orthopaedic treatment makes it interesting and challenging to be involved in the treatment of professional athletes. In the

  6. The EOS imaging system: Workflow and radiation dose in scoliosis examinations

    DEFF Research Database (Denmark)

    Mussmann, Bo; Torfing, Trine; Jespersen, Stig

    Introduction The EOS imaging system is a biplane slot beam scanner capable of full body scans at low radiation dose and without geometrical distortion. It was implemented in our department primo 2012 and all scoliosis examinations are now performed in EOS. The system offers improved possibility...... The purpose of the study was to evaluate workflow defined as scheduled time pr. examination and radiation dose in scoliosis examinations in EOS compared to conventional x-ray evaluation. Materials and Methods: The Dose Area Product (DAP) was measured with a dosimeter and a comparison between conventional X......-ray and EOS was made. The Workflow in 2011 was compared to the workflow in 2013 with regards to the total number of examinations and the scheduled examination time for scoliosis examinations. Results: DAP for a scoliosis examination in conventional X-ray was 185 mGy*cm2 and 60.36 mGy*cm2 for EOS...

  7. Image Processing : An Enabler for Future EO System Concepts

    NARCIS (Netherlands)

    Schutte, K.; Schwering, P.B.W.


    The current state of the art in electro-optics provides systems with high image quality for associated prices and less expensive systems with subsequent lower performance. This keynote will expound how image processing enables to obtain high quality imagery while utilizing affordable system

  8. An evaluation of the EOS X-ray imaging system in pelvimetry

    International Nuclear Information System (INIS)

    Sigmann, M.H.; Runge, M.; Peyron, C.; Delabrousse, E.; Riethmuller, D.; Aubry, S.


    Objectives: To demonstrate the reliability of the EOS imaging system in measuring the internal diameters of the bony pelvis. Materials and methods: A prospective study comparing the results of the pelvimetry of 18 dry pelvises carried out on the EOS imaging system to measurements taken manually and using the two current gold standard CT methods. Pelvi-metric measurements of each pelvic bone were obtained using four methods and compared: direct manual measurements, spiral and sequential CT pelvimetry, and 2D-3D low-dose bi-planar X-rays. The various obstetric diameters were measured to the millimetre and compared. Results: There was no significant difference in the different diameters assessed, with the exception of the inter-spinous diameter. There was a highly significant correlation (P < 0.001) between the values measured manually and by EOS for the Magnin index (Pearson = 0.98), the obstetric conjugate diameter (Pearson = 0.99), and the median transverse diameter (Pearson = 0.87). Conclusion: The EOS imaging system allows for an ex vivo determination of the obstetrical diameters that is reliable enough to estimate obstetric prognosis, producing comparable measurements to CT. In view of concerns about protection from radiation, this low-dose imaging technique could become, after in vivo prospective validation, the new gold standard for pelvimetry and therefore a good alternative to CT. (authors)

  9. Imaging in scoliosis from the orthopaedic surgeon's point of view

    Energy Technology Data Exchange (ETDEWEB)

    Thomsen, Marc [Stiftung Orthopaedische Universitaetsklinik Heidelberg, Schlierbacher Landstr. 200a, 69118 Heidelberg (Germany); Abel, Rainer [Stiftung Orthopaedische Universitaetsklinik Heidelberg, Schlierbacher Landstr. 200a, 69118 Heidelberg (Germany)]. E-mail:


    For treating patients with scoliosis orthopaedic surgeons need diagnostic imaging procedures in order to provide answers about a possible underlying disease, choice of treatment, and prognosis. Once treatment is instituted, imaging is also critical for monitoring changes of the deformity so as to optimize therapy. The combined effort of orthopaedic surgeons and radiologists helps detect treatable causes of scoliosis at an early stage, define the need and timing for surgery, and ensure that every precaution is taken to minimize the risks of surgery. Neurosurgical causes, with particular reference to spinal cord tumours and syringomyelia, need to be addressed before scoliosis surgery can be contemplated.

  10. Vegetation Canopy Structure from NASA EOS Multiangle Imaging (United States)

    Chopping, M.; Martonchik, J. V.; Bull, M.; Rango, A.; Schaaf, C. B.; Zhao, F.; Wang, Z.


    We used red band bidirectional reflectance data from the NASA Multiangle Imaging SpectroRadiometer (MISR) and the MODerate resolution Imaging Spectroradiometer (MODIS) mapped onto a 250 m grid in a multiangle approach to obtain estimates of woody plant fractional cover and crown height through adjustment of the mean radius and mean crown aspect ratio parameters of an hybrid geometric-optical (GO) model. We used a technique to rapidly obtain MISR surface reflectance estimates at 275 m resolution through regression on 1 km MISR land surface estimates previously corrected for atmospheric attenuation using MISR aerosol estimates. MISR data were used to make end of dry season maps from 2000-2007 for parts of southern New Mexico, while MODIS data were used to replicate previous results obtained using MISR for June 2002 over large parts of New Mexico and Arizona. We also examined the applicability of this method in Alaskan tundra and forest by adjusting the GO model against MISR data for winter (March 2000) and summer (August 2008) scenes. We found that the GO model crown aspect ratio from MISR followed dominant shrub species distributions in the USDA, ARS Jornada Experimental Range, enabling differentiation of the more spherical crowns of creosotebush (Larrea tridentata) from the more prolate crowns of honey mesquite (Prosopis glandulosa). The measurement limits determined from 2000-2007 maps for a large part of southern New Mexico are ~0.1 in fractional shrub crown cover and ~3 m in mean canopy height (results obtained using data acquired shortly after precipitation events that radically darkened and altered the structure and angular response of the background). Typical standard deviations over the period for 12 sites covering a range of cover types are on the order of 0.05 in crown cover and 2 m in mean canopy height. We found that the GO model can be inverted to retrieve reasonable distributions of canopy parameters in southwestern environments using MODIS V005 red

  11. EOS imaging of the human pelvis: reliability, validity, and controlled comparison with radiography. (United States)

    Bittersohl, Bernd; Freitas, Joana; Zaps, Daniela; Schmitz, Matthew R; Bomar, James D; Muhamad, Abd R; Hosalkar, Harish S


    The EOS technique represents a unique imaging modality combining low radiation exposure with high image quality. As its applications for pelvic imaging may increase with time, we performed a pilot study to evaluate the validity and reliability of this technique for the assessment of gross pelvic and acetabular morphology. Consecutive conventional and EOS radiographs of a human cadaveric pelvis were made in 5° intervals of sagittal tilt and axial rotation (range, -15° to 15° for each). Six measurements were made on each image: (1) the vertical distance between the sacrococcygeal joint and the upper border of the pubic symphysis, (2) the horizontal distance between the midpoints of these structures, (3) the distance between the anterior superior iliac spines, (4) the distance between the facets of S1, (5) the Sharp angle, and (6) the Tönnis angle. Coxa profunda and crossover signs were also evaluated. The findings of the two imaging techniques were correlated with each other and with true linear measurements made on the cadaveric pelvis. All measurements were performed by two independent observers, and one observer repeated all measurements to assess reproducibility. Both observers were blinded to the true linear measurements made on the pelvis. There was a strong correlation between the results of the conventional and EOS radiography (Pearson correlation coefficient, 0.644 to 0.998), and both modalities had high intraobserver and interobserver reproducibility (intraclass correlation coefficient, 0.795 to 1.000). Intraobserver and interobserver agreement on the presence of coxa profunda were both 100%. Intraobserver agreement (96.2%) and interobserver agreement (92.3%) on the presence of the crossover sign were marginally lower. Linear measurements differed significantly between the two modalities because of distortion caused by magnification effects in the conventional radiographic imaging (p < 0.05). The EOS imaging technique proved reliable for the assessment

  12. The moderate resolution imaging spectrometer: An EOS facility instrument candidate for application of data compression methods (United States)

    Salomonson, Vincent V.


    The Moderate Resolution Imaging Spectrometer (MODIS) observing facility will operate on the Earth Observing System (EOS) in the late 1990's. It is estimated that this observing facility will produce over 200 gigabytes of data per day requiring a storage capability of just over 300 gigabytes per day. Archiving, browsing, and distributing the data associated with MODIS represents a rich opportunity for testing and applying both lossless and lossy data compression methods.

  13. Occupational and patient exposure as well as image quality for full spine examinations with the EOS imaging system

    Energy Technology Data Exchange (ETDEWEB)

    Damet, J., E-mail:; Fournier, P.; Monnin, P.; Sans-Merce, M.; Verdun, F. R.; Baechler, S. [Institute of Radiation Physics, Lausanne University Hospital, Lausanne 1007 (Switzerland); Ceroni, D. [Department of Paediatrics, Division of paediatric orthopaedic, University Hospitals of Geneva, Geneva 1205 (Switzerland); Zand, T. [Department of Radiology, Division of paediatric radiology, University Hospitals of Geneva, Geneva 1205 (Switzerland)


    Purpose: EOS (EOS imaging S.A, Paris, France) is an x-ray imaging system that uses slot-scanning technology in order to optimize the trade-off between image quality and dose. The goal of this study was to characterize the EOS system in terms of occupational exposure, organ doses to patients as well as image quality for full spine examinations. Methods: Occupational exposure was determined by measuring the ambient dose equivalents in the radiological room during a standard full spine examination. The patient dosimetry was performed using anthropomorphic phantoms representing an adolescent and a five-year-old child. The organ doses were measured with thermoluminescent detectors and then used to calculate effective doses. Patient exposure with EOS was then compared to dose levels reported for conventional radiological systems. Image quality was assessed in terms of spatial resolution and different noise contributions to evaluate the detector's performances of the system. The spatial-frequency signal transfer efficiency of the imaging system was quantified by the detective quantum efficiency (DQE). Results: The use of a protective apron when the medical staff or parents have to stand near to the cubicle in the radiological room is recommended. The estimated effective dose to patients undergoing a full spine examination with the EOS system was 290μSv for an adult and 200 μSv for a child. MTF and NPS are nonisotropic, with higher values in the scanning direction; they are in addition energy-dependent, but scanning speed independent. The system was shown to be quantum-limited, with a maximum DQE of 13%. The relevance of the DQE for slot-scanning system has been addressed. Conclusions: As a summary, the estimated effective dose was 290μSv for an adult; the image quality remains comparable to conventional systems.

  14. Three-dimensional image display by CT data processing and clinical applications in orthopaedics and craniofacial surgery

    International Nuclear Information System (INIS)

    Zonneveld, F.W.; Akkerveeken, P.F. van; Koornneef, L.


    The methods of generating three-dimensional images from two-dimensional CT data are described. Four cases are reported explaining its use in the planning of orthopaedic and craniofacial surgery. (orig.) [de

  15. A view on EOS (United States)

    Lucchitta, Baerbel K.


    I am replying to the recent solicitation to provide views on NASA's Earth Observing System (EOS) to an AGU panel (Eos, October 3, p. 886). My view concerns Landsat. A flashy EOS poster, recently distributed, features six images from space; three of these are from the Landsat satellite. Yet no Landsat-type imaging system is contemplated for EOS. Imaging systems such as HIRIS and HRIS (high-resolution imaging spectrometers) do not give the synoptic view of Landsat and are much too elaborate for simple but invaluable observations of many global- scale processes.

  16. Multi-modal imaging, model-based tracking, and mixed reality visualisation for orthopaedic surgery. (United States)

    Lee, Sing Chun; Fuerst, Bernhard; Tateno, Keisuke; Johnson, Alex; Fotouhi, Javad; Osgood, Greg; Tombari, Federico; Navab, Nassir


    Orthopaedic surgeons are still following the decades old workflow of using dozens of two-dimensional fluoroscopic images to drill through complex 3D structures, e.g. pelvis. This Letter presents a mixed reality support system, which incorporates multi-modal data fusion and model-based surgical tool tracking for creating a mixed reality environment supporting screw placement in orthopaedic surgery. A red-green-blue-depth camera is rigidly attached to a mobile C-arm and is calibrated to the cone-beam computed tomography (CBCT) imaging space via iterative closest point algorithm. This allows real-time automatic fusion of reconstructed surface and/or 3D point clouds and synthetic fluoroscopic images obtained through CBCT imaging. An adapted 3D model-based tracking algorithm with automatic tool segmentation allows for tracking of the surgical tools occluded by hand. This proposed interactive 3D mixed reality environment provides an intuitive understanding of the surgical site and supports surgeons in quickly localising the entry point and orienting the surgical tool during screw placement. The authors validate the augmentation by measuring target registration error and also evaluate the tracking accuracy in the presence of partial occlusion.

  17. Direct Geolocation of Satellite Images with the EO-CFI Libraries (United States)

    de Miguel, Eduardo; Prado, Elena; Estebanez, Monica; Martin, Ana I.; Gonzalez, Malena


    The INTA Remote Sensing Laboratory has implemented a tool for the direct geolocation of satellite images. The core of the tool is a C code based on the "Earth Observation Mission CFI SW" from ESA. The tool accepts different types of inputs for satellite attitude (euler angles, quaternions, default attitude models). Satellite position can be provided either in ECEF or ECI coordinates. The line of sight of each individual detector is imported from an external file or is generated by the tool from camera parameters. Global DEM ACE2 is used to define ground intersection of the LOS.The tool has been already tailored for georeferencing images from the forthcoming Spanish Earth Observation mission SEOSat/Ingenio, and for the camera APIS onboard the INTA cubesat OPTOS. The next step is to configure it for the geolocation of Sentinel 2 L1b images.The tool has been internally validated by different means. This validation shows that the tool is suitable for georeferencing images from high spatial resolution missions. As part of the validation efforts, a code for simulating orbital info for LEO missions using EO-CFI has been produced.

  18. Three-dimensional imaging of the spine using the EOS system: is it reliable? A comparative study using computed tomography imaging

    DEFF Research Database (Denmark)

    Al-Aubaidi, Z.; Lebel, D.; Oudjhane, K.


    The aim of this study was to evaluate the precision of three-dimensional geometry compared with computed tomography (CT) images. This retrospective study included patients who had undergone both imaging of the spine using the EOS imaging system and CT scanning of the spine. The apical vertebral o...

  19. Assessment of prosthesis alignment after revision total knee arthroplasty using EOS 2D and 3D imaging: a reliability study.

    Directory of Open Access Journals (Sweden)

    Marrigje F Meijer

    Full Text Available INTRODUCTION: A new low-dose X-ray device, called EOS, has been introduced for determining lower-limb alignment in 2D and 3D. Reliability has not yet been assessed when using EOS on lower limbs containing a knee prosthesis. Therefore purpose of this study was to determine intraobserver and interobserver reliability of EOS 2D and 3D knee prosthesis alignment measurements after revision total knee arthroplasty (rTKA. METHODS: Forty anteroposterior and lateral images of 37 rTKA patients were included. Two observers independently performed measurements on these images twice. Varus/valgus angles were measured in 2D (VV2D and 3D (VV3D. Intraclass correlation coefficients and the Bland and Altman method were used to determine reliability. T-tests were used to test potential differences. RESULTS: Intraobserver and interobserver reliability were excellent for VV2D and VV3D. No significant difference or bias between the first and second measurements or the two observers was found. A significant mean and absolute difference of respectively 1.00° and 1.61° existed between 2D and 3D measurements. CONCLUSIONS: EOS provides reliable varus/valgus measurements in 2D and 3D for the alignment of the knee joint with a knee prosthesis. However, significant differences exist between varus/valgus measurements in 2D and 3D.

  20. Prospective study of irradiation and magnification on a pelvic imaging: EOS system versus conventional radiography

    International Nuclear Information System (INIS)

    Demoulin, Loic


    The pelvic x-ray is essential for the orthopedic practise. Recently, EOS system has been developed with technology to limit irradiation and theoretically not create magnification. The objective of this study was to evaluate the EOS system realizing a pelvic x-ray. All patients who underwent hip replacement between September 2014 and April 2015 have benefited pelvis radiograph with the 2 techniques, after surgery. The size of the head was measured with both techniques and compared to the established size. Irradiation of each technique was listed. A correlation study was carried out with the body mass index (BMI) of the patient. Irradiation was significantly greater with conventional radiography than with the EOS system: PDS of conventional radiography = 15.0 (10.5; 25.2) against the EOS system PDS = 8.2 (7.1; 9.7), p ≤0.0001. It was found a significant correlation between BMI and irradiation, particularly with conventional radiography. About expansion, the EOS system not create any except in 4 cases, unlike the conventional radiograph. The EOS system significantly decreases irradiation in all patients, compared to the conventional radiography, and it do not create magnification when realizing a pelvic x-ray, even in overweight patients [fr


    Energy Technology Data Exchange (ETDEWEB)

    Kohn, S. A.; Aguirre, J. E.; Moore, D. F. [Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA (United States); Nunhokee, C. D.; Bernardi, G. [Department of Physics and Electronics, Rhodes University, Grahamstown (South Africa); Pober, J. C. [Department of Physics, Brown University, Providence, RI (United States); Ali, Z. S.; DeBoer, D. R.; Parsons, A. R. [Astronomy Department, University of California, Berkeley, CA (United States); Bradley, R. F. [Department of Electrical and Computer Engineering, University of Virginia, Charlottesville, VA (United States); Carilli, C. L. [National Radio Astronomy Observatory, Socorro, NM (United States); Gugliucci, N. E. [Saint Anselm College, Manchester, NH (United States); Jacobs, D. C. [School of Earth and Space Exploration, Arizona State University, Tempe, AZ (United States); Klima, P. [National Radio Astronomy Observatory, Charlottesville, VA (United States); MacMahon, D. H. E. [Radio Astronomy Laboratory, University of California, Berkeley, CA (United States); Manley, J. R.; Walbrugh, W. P. [SKA South Africa, Pinelands (South Africa); Stefan, I. I., E-mail: [Cavendish Laboratory, Cambridge (United Kingdom)


    Current generation low-frequency interferometers constructed with the objective of detecting the high-redshift 21 cm background aim to generate power spectra of the brightness temperature contrast of neutral hydrogen in primordial intergalactic medium. Two-dimensional (2D) power spectra (power in Fourier modes parallel and perpendicular to the line of sight) that formed from interferometric visibilities have been shown to delineate a boundary between spectrally smooth foregrounds (known as the wedge ) and spectrally structured 21 cm background emission (the EoR window ). However, polarized foregrounds are known to possess spectral structure due to Faraday rotation, which can leak into the EoR window. In this work we create and analyze 2D power spectra from the PAPER-32 imaging array in Stokes I, Q, U, and V. These allow us to observe and diagnose systematic effects in our calibration at high signal-to-noise within the Fourier space most relevant to EoR experiments. We observe well-defined windows in the Stokes visibilities, with Stokes Q, U, and V power spectra sharing a similar wedge shape to that seen in Stokes I. With modest polarization calibration, we see no evidence that polarization calibration errors move power outside the wedge in any Stokes visibility to the noise levels attained. Deeper integrations will be required to confirm that this behavior persists to the depth required for EoR detection.

  2. The EOS imaging system: Workflow and radiation dose in scoliosis examinations

    DEFF Research Database (Denmark)

    Mussmann, Bo; Torfing, Trine; Jespersen, Stig

    The purpose of the study was to evaluate workflow defined as scheduled time pr. examination and radiation dose in scoliosis examinations in EOS compared to conventional x-ray evaluation. Materials and Methods: The Dose Area Product (DAP) was measured with a dosimeter and a comparison between conventional X......-ray and EOS was made. The Workflow in 2011 was compared to the workflow in 2013 with regards to the total number of examinations and the scheduled examination time for scoliosis examinations. Results: DAP for a scoliosis examination in conventional X-ray was 185 mGy*cm2 and 60.36 mGy*cm2 for EOS...... to approximately 30 % of the radiation dose in conventional X-ray. The increased number of scoliosis examinations is related to increased referral and not due to optimized workflow....

  3. EOS developments (United States)

    Sindrilaru, Elvin A.; Peters, Andreas J.; Adde, Geoffray M.; Duellmann, Dirk


    CERN has been developing and operating EOS as a disk storage solution successfully for over 6 years. The CERN deployment provides 135 PB and stores 1.2 billion replicas distributed over two computer centres. Deployment includes four LHC instances, a shared instance for smaller experiments and since last year an instance for individual user data as well. The user instance represents the backbone of the CERNBOX service for file sharing. New use cases like synchronisation and sharing, the planned migration to reduce AFS usage at CERN and the continuous growth has brought EOS to new challenges. Recent developments include the integration and evaluation of various technologies to do the transition from a single active in-memory namespace to a scale-out implementation distributed over many meta-data servers. The new architecture aims to separate the data from the application logic and user interface code, thus providing flexibility and scalability to the namespace component. Another important goal is to provide EOS as a CERN-wide mounted filesystem with strong authentication making it a single storage repository accessible via various services and front- ends (/eos initiative). This required new developments in the security infrastructure of the EOS FUSE implementation. Furthermore, there were a series of improvements targeting the end-user experience like tighter consistency and latency optimisations. In collaboration with Seagate as Openlab partner, EOS has a complete integration of OpenKinetic object drive cluster as a high-throughput, high-availability, low-cost storage solution. This contribution will discuss these three main development projects and present new performance metrics.

  4. Spectral mixture analysis for water quality assessment over the Amazon floodplain using Hyperion/EO-1 images

    Directory of Open Access Journals (Sweden)

    Lênio Soares Galvão


    Full Text Available Water composition undergoes complex spatial and temporal variations throughout the central Amazon floodplain. This study analyzed the spectral mixtures of the optically active substances (OASs in water with spaceborne hyperspectral images. The test site was located upstream the confluence of Amazon (white water and Tapajós (clear-water rivers, where two Hyperion images were acquired from the Earth Observing One (EO-1 satellite. The first image was acquired on September 16, 2001, during the falling water period of the Amazon River. The second image was acquired on June 23, 2005, at the end of the high water period. The images were pre-processed to remove stripes of anomalous pixels, convert radiance-calibrated data to surface reflectance, mask land, clouds and macrophytes targets, and spectral subset the data within the range of 457-885nm. A sequential procedure with the techniques Minimum Noise Fraction (MNF, Pixel Purity Index (PPI and n-dimensional visualization of the MNF feature space was employed to select end-members from both images. A single set of end-members was gathered to represent the following spectrally unique OASs: clear-water; dissolved organic matter; suspended sediments; and phytoplankton. The Linear Spectral Unmixing algorithm was applied to each Hyperion image in order to map the spatial distribution of these constituents, in terms of sub-pixel fractional abundances. Results showed three patterns of changes in the water quality from high to falling flood periods: decrease of suspended inorganic matter concentration in the Amazon River; increase of suspended inorganic matter and phytoplankton concentrations in varzea lakes; and increase of phytoplankton concentration in the Tapajós River.

  5. Development and validation of a subject-specific moving-axis tibiofemoral joint model using MRI and EOS imaging during a quasi-static lunge

    DEFF Research Database (Denmark)

    Dzialo, C M; Pedersen, P H; Simonsen, C W


    The aims of this study were to introduce and validate a novel computationally-efficient subject-specific tibiofemoral joint model. Subjects performed a quasi-static lunge while micro-dose radiation bi-planar X-rays (EOS Imaging, Paris, France) were captured at roughly 0°, 20°, 45°, 60°, and 90° o...

  6. Assessment of Prosthesis Alignment after Revision Total Knee Arthroplasty Using EOS 2D and 3D Imaging : A Reliability Study

    NARCIS (Netherlands)

    Meijer, Marrigje F.; Boerboom, Alexander L.; Stevens, Martin; Bulstra, Sjoerd K.; Reininga, Inge H. F.


    Introduction: A new low-dose X-ray device, called EOS, has been introduced for determining lower-limb alignment in 2D and 3D. Reliability has not yet been assessed when using EOS on lower limbs containing a knee prosthesis. Therefore purpose of this study was to determine intraobserver and

  7. EOS Inoovation Photo's

    International Nuclear Information System (INIS)


    What did four years of energy innovation bring the Netherlands? Which are the main lessons learned and what are the best opportunities for the market? The Energy Research Strategy programme (EOS) gave the answers to these questions for various topics in the form of images by means of so-called I nnovation Photos' on Biomass, Built Environment, Industrial Energy Efficiency, Smart Grids, Heat, Offshore Wind, and Solar PV. [nl

  8. Image Processing, the Way Ahead for IR/EO Sensor Improvements?

    NARCIS (Netherlands)

    Schutte, K.


    Developments in the past in the field of InfraRed camera systems have been impressive. In the fifties of the previous century the first InfraRed images have been produced, with military cameras following a decade later. Standardization into a commodity started another decade later with the

  9. Margin-of-safety Algorithm Used with EOS Imaging to Interpret MHRA Warning for 46-48mm MOM Arthroplasty

    Directory of Open Access Journals (Sweden)

    Ian Clarke


    Full Text Available The Medical Healthcare Products Regulatory Agency (MHRA June-2015 warned of higher risks with 46-48mm sizes of BHR hip resurfacing arthroplasty (HRA. The most common condemnation of adverse results in MOM bearings has been termed edge loading. We originally developed a margin-of-safety (MOS algorithm to define edge loading of cups in simulator studies. This method integrated simulator wear-patterns with respect to cup diameters and cup designs. The algorithm’s simplicity lay in the fact that with wear-patterns and rim-profile angles predetermined, the only input required was the cup inclination-angle. The algorithm demonstrated that the margin-of-safety decreased in smaller cups due to the tribo-mechanics of spherical CoCr bearings, a previously unrecognized feature. For the 46mm and 48mm cups highlighted in the MHRA alert, the critical cup inclinations where edge-wear became a risk occurred at 65-66°, revealing an insignificant difference with respect to diameters. The MOS-algorithm also indicated that lower lateral-inclination angles were particularly beneficial, i.e. a 46mm cup positioned at 50° inclination would exhibit a higher margin of safety than either 48mm or 50mm sizes positioned at 55° inclination. This evidence supported clinical studies that recommended BHR cup inclinations up to 50-55° and lower as optimal for reducing metal-ion concentrations. In a patient with normal spine mobility, our EOS imaging demonstrated that the inclination in the 46mm cup steepened by 9° from standing to the seated position while margin-of-safety was reduced by 50%. Our 2nd patient with a stiff spine sat with the same component orientations as in his standing posture. Thus MOM impingement and subluxation in different functional postures may also provoke rim-damage mechanisms. Here the combination of EOS imaging and the MOS-algorithm may aid understanding of such risks. Thus the margin-of-safety algorithm confirmed and helped explained the

  10. Development of a user-friendly system for image processing of electron microscopy by integrating a web browser and PIONE with Eos. (United States)

    Tsukamoto, Takafumi; Yasunaga, Takuo


    Eos (Extensible object-oriented system) is one of the powerful applications for image processing of electron micrographs. In usual cases, Eos works with only character user interfaces (CUI) under the operating systems (OS) such as OS-X or Linux, not user-friendly. Thus, users of Eos need to be expert at image processing of electron micrographs, and have a little knowledge of computer science, as well. However, all the persons who require Eos does not an expert for CUI. Thus we extended Eos to a web system independent of OS with graphical user interfaces (GUI) by integrating web browser.Advantage to use web browser is not only to extend Eos with GUI, but also extend Eos to work under distributed computational environment. Using Ajax (Asynchronous JavaScript and XML) technology, we implemented more comfortable user-interface on web browser. Eos has more than 400 commands related to image processing for electron microscopy, and the usage of each command is different from each other. Since the beginning of development, Eos has managed their user-interface by using the interface definition file of "OptionControlFile" written in CSV (Comma-Separated Value) format, i.e., Each command has "OptionControlFile", which notes information for interface and its usage generation. Developed GUI system called "Zephyr" (Zone for Easy Processing of HYpermedia Resources) also accessed "OptionControlFIle" and produced a web user-interface automatically, because its mechanism is mature and convenient,The basic actions of client side system was implemented properly and can supply auto-generation of web-form, which has functions of execution, image preview, file-uploading to a web server. Thus the system can execute Eos commands with unique options for each commands, and process image analysis. There remain problems of image file format for visualization and workspace for analysis: The image file format information is useful to check whether the input/output file is correct and we also

  11. Comparison of hyperspectral transformation accuracies of multispectral Landsat TM, ETM+, OLI and EO-1 ALI images for detecting minerals in a geothermal prospect area (United States)

    Hoang, Nguyen Tien; Koike, Katsuaki


    Hyperspectral remote sensing generally provides more detailed spectral information and greater accuracy than multispectral remote sensing for identification of surface materials. However, there have been no hyperspectral imagers that cover the entire Earth surface. This lack points to a need for producing pseudo-hyperspectral imagery by hyperspectral transformation from multispectral images. We have recently developed such a method, a Pseudo-Hyperspectral Image Transformation Algorithm (PHITA), which transforms Landsat 7 ETM+ images into pseudo-EO-1 Hyperion images using multiple linear regression models of ETM+ and Hyperion band reflectance data. This study extends the PHITA to transform TM, OLI, and EO-1 ALI sensor images into pseudo-Hyperion images. By choosing a part of the Fish Lake Valley geothermal prospect area in the western United States for study, the pseudo-Hyperion images produced from the TM, ETM+, OLI, and ALI images by PHITA were confirmed to be applicable to mineral mapping. Using a reference map as the truth, three main minerals (muscovite and chlorite mixture, opal, and calcite) were identified with high overall accuracies from the pseudo-images (> 95% and > 42% for excluding and including unclassified pixels, respectively). The highest accuracy was obtained from the ALI image, followed by ETM+, TM, and OLI images in descending order. The TM, OLI, and ALI images can be alternatives to ETM+ imagery for the hyperspectral transformation that aids the production of pseudo-Hyperion images for areas without high-quality ETM+ images because of scan line corrector failure, and for long-term global monitoring of land surfaces.

  12. Radiologically defining horizontal gaze using EOS imaging-a prospective study of healthy subjects and a retrospective audit. (United States)

    Hey, Hwee Weng Dennis; Tan, Kimberly-Anne; Ho, Vivienne Chien-Lin; Azhar, Syifa Bte; Lim, Joel-Louis; Liu, Gabriel Ka-Po; Wong, Hee-Kit


    As sagittal alignment of the cervical spine is important for maintaining horizontal gaze, it is important to determine the former for surgical correction. However, horizontal gaze remains poorly-defined from a radiological point of view. The objective of this study was to establish radiological criteria to define horizontal gaze. This study was conducted at a tertiary health-care institution over a 1-month period. A prospective cohort of healthy patients was used to determine the best radiological criteria for defining horizontal gaze. A retrospective cohort of patients without rigid spinal deformities was used to audit the incidence of horizontal gaze. Two categories of radiological parameters for determining horizontal gaze were tested: (1) the vertical offset distances of key identifiable structures from the horizontal gaze axis and (2) imaginary lines convergent with the horizontal gaze axis. Sixty-seven healthy subjects underwent whole-body EOS radiographs taken in a directed standing posture. Horizontal gaze was radiologically defined using each parameter, as represented by their means, 95% confidence intervals (CIs), and associated 2 standard deviations (SDs). Subsequently, applying the radiological criteria, we conducted a retrospective audit of such radiographs (before the implementation of a strict radioimaging standardization). The mean age of our prospective cohort was 46.8 years, whereas that of our retrospective cohort was 37.2 years. Gender was evenly distributed across both cohorts. The four parameters with the lowest 95% CI and 2 SD were the distance offsets of the midpoint of the hard palate (A) and the base of the sella turcica (B), the horizontal convergents formed by the tangential line to the hard palate (C), and the line joining the center of the orbital orifice with the internal occipital protuberance (D). In the prospective cohort, good sensitivity (>98%) was attained when two or more parameters were used. Audit using Criterion B

  13. Ethernet over SDH (EoS): Summary

    Indian Academy of Sciences (India)

    EoS provides point-to-point LAN services over an SDH backbone. 10/100/1000 Mbps Ethernet tributaries (client ports) directly on the SDH equipment used to provide “leased lines” ... Bandwidth-on-demand, even for short time-periods. Software-control enables services like bandwidth-on-demand ...

  14. A new imaging 2D and 3D for musculo-skeletal physiology and pathology with low radiation dose and standing position: the EOS system; Une nouvelle imagerie osteo-articulaire basse dose en position debout: le systeme EOS

    Energy Technology Data Exchange (ETDEWEB)

    Dubousset, J. [Academie Nationale de Medecine, et Hopital Saint Vincent de Paul, Service de Chirurgie Orthopedique, 75 - Paris (France); Charpak, G.; Dorion, I. [Biospace, Instruments, 75 - Paris (France); Skalli, W.; Lavaste, F. [Ecole Nationale Superieure des Arts et Metiers, 75 - Paris (France); Deguise, J. [Laboratoire de Recherche en Imagerie Orthopedique, Montreal (Canada); Kalifa, G.; Ferey, S. [Hopital Saint Vincent de Paul, Service de Radiologie, 75 - Paris (France)


    Very precise combined work between multidisciplinary partners (radiation engineers in physics, engineers in bio-mechanics, medical radiologists and orthopedic pediatric surgeons) lead to the concept and development of a new low dose radiation device named EOS. This device allows 3 main advantages: (1) thanks to the invention of Georges Charpak (Nobel Price 1992) who designed gaseous detectors for X-rays, the reduction of dose necessary to obtain a good image of skeletal system was 8 to 10 times less for 2D imaging, compared to the dose necessary to obtain a 3D reconstruction from CT scan cuts the reduction factor was 800 to 1000. (2) The accuracy of 3D reconstruction obtained is as good as a 3D reconstruction from CT scan cuts. (3) The patient in addition get its imaging in standing functional position thank to the X-rays obtained from head to feet simultaneously AP and lateral. This is a big advantage compared to CT scan used only in lying position. From this simultaneous AP and lateral X-rays of the whole body thanks to the 3D bone external envelop technique, the engineers in bio-mechanics allowed to obtain 3D reconstruction of every level of osteo-articular system in standing position with an acceptable period of time (15 to 30 minutes). This (in spite of the evolution of standing MRI) allows more precise bone reconstruction in orthopedics especially at the level of spine, lower limbs, etc. In addition the fact to study the entire skeleton in standing functional position instead of small segmented studies given by CT scan in lying position produce a real improvement as well for physiology as for pathology of bone and joints disorders and especially for spinal pathology. (author)

  15. Clinical validation of the avidin/indium-111 biotin approach for imaging infection/inflammation in orthopaedic patients

    International Nuclear Information System (INIS)

    Lazzeri, E.; Molea, N.; Bodei, L.; Bianchi, R.; Manca, M.; Marchetti, S.; Consoli, V.; Chinol, M.; Paganelli, G.; Mariani, G.


    We report here the results of a validation study of the avidin/indium-111 biotin approach in patients with skeletal lesions. This study involved 54 patients with orthopaedic conditions: 20 patients with intermediate suspected osteomyelitis of the trunk, 19 patients with infection/inflammation of prosthetic joint replacements, and 15 patients with suspected osteomyelitis of appendicular bones. Avidin (3 mg) was injected as an i.v. bolus, followed 4 h later by 111 In-biotin; imaging was acquired 30 min and 16-18 h after administration of 111 In-biotin. Technetium-99m hexamethylpropylene amine oxime ( 99m Tc-HMPAO)-labelled leucocyte scintigraphy was performed in 39/54 patients. The overall sensitivity of the avidin/ 111 In-biotin scan was 97.7% (versus 88.9% for 99m Tc-HMPAO leucocyte scintigraphy). While the diagnostic performance of avidin/ 111 In-biotin scintigraphy was similar to that of 99m Tc-HMPAO leucocyte scintigraphy in patients with prosthetic joint replacements or osteomyelitis of appendicular bones, the avidin/ 111 In-biotin approach clearly performed better than 99m Tc-HMPAO leucocyte scintigraphy in patients with suspected osteomyelitis of the trunk (100% sensitivity, specificity and accuracy versus 50% sensitivity, 100% specificity and 66.7% accuracy for 99m Tc-HMPAO-leucocyte scintigraphy). These results demonstrate the feasibility of the avidin/ 111 In-biotin approach for imaging sites of infection/inflammation in the clinical setting. Although no systematic advantages of avidin/ 111 In-biotin scintigraphy were found versus 99m Tc-HMPAO leucocyte scintigraphy, the newer scintigraphic method is more practicable and involves lower biological risk for the operators. (orig.)

  16. Computational radiology for orthopaedic interventions

    CERN Document Server

    Li, Shuo


    This book provides a cohesive overview of the current technological advances in computational radiology, and their applications in orthopaedic interventions. Contributed by the leading researchers in the field, this volume covers not only basic computational radiology techniques such as statistical shape modeling, CT/MRI segmentation, augmented reality and micro-CT image processing, but also the applications of these techniques to various orthopaedic interventional tasks. Details about following important state-of-the-art development are featured: 3D preoperative planning and patient-specific instrumentation for surgical treatment of long-bone deformities, computer assisted diagnosis and planning of periacetabular osteotomy and femoroacetabular impingement, 2D-3D reconstruction-based planning of total hip arthroplasty, image fusion for  computer-assisted bone tumor surgery, intra-operative three-dimensional imaging in fracture treatment, augmented reality based orthopaedic interventions and education, medica...

  17. Giant cell tumor of the tendon sheath of the hand - magnetic resonance image and orthopaedic treatment

    International Nuclear Information System (INIS)

    Kirova, G.; Monovska, T.; Jablanski, V.; Alexieva, K.; Velev, M.


    Giant cell tumour of the tendon sheath (GCT-TS), also known as localized nodular tenosynovitis, is a benign neoplasm that occurs dominantly on the digits. These tumours most commonly occur in patients aged 30-50 years and are associated with degenerative joint disease. GCT-TS usually arises from the synovium of tendon sheets, affecting interfalangeal joints of the hand, feet, ankle and knees. Magnetic Resonance Imaging is able to depict characteristic signal intensities and can accurately assess the tumor size and degree of extent around the phalanx. We present a case of a 36 years-old male patient with GCT-TS in the flexor tendon of his left second finger, diagnosed with Magnetic Resonance imaging. The mass was excised widely with preservation of the flexor tendon without recurrence. (authors)

  18. Eos Chasma Landslides (United States)


    [figure removed for brevity, see original site] This VIS image shows several landslides within Eos Chasma. Many very large landslides have occurred within different portions of Valles Marineris. Note where the northern wall has failed in a upside-down bowl shape, releasing the material that formed the landslide deposit. Image information: VIS instrument. Latitude -8, Longitude 318.6 East (41.4 West). 19 meter/pixel resolution. Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time. NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  19. Novel applications of near-infrared fluorescence imaging in orthopaedic surgery (Conference Presentation) (United States)

    Henderson, Eric R.; DSouza, Alisha V.; Paulsen, Keith D.; Pogue, Brian W.


    Sarcomas are cancers of the bones, muscles, nerves, and fat that require complete surgical removal for cure. The primary surgical goal therefore is to remove the tumor with a zone of normal, non-cancerous tissue surrounding the tumor, considered a `negative' surgical margin. At present, surgeons rely on radiologic imaging and visual and tactile clues to gauge cancer depth and guide surgical excision. This can result in removal of too much or too little tissue, which can lead to unnecessary removal of vital structures or incomplete cancer removal, respectively. Both results can have negative effects on ultimate patient outcome, with positive margins reported in 23% of sarcoma surgeries. Near-infrared (NIR) fluorescence probes are molecules that when stimulated with specific, known frequencies of near-infrared light will emit light of another distinct frequency. NIR light penetrates human tissue reasonably well and therefore can be used to detect the presence and location of unseen structures labeled with NIR fluorescence probes through several centimeters of tissue. Intra-operative near-infrared (NIR) fluorescence probes have been effective for this purpose in brain tumor surgery and may be applicable to sarcoma surgery. Foundational research is needed to explore the potential of this affibody probe and perfusion probes to estimate margin thickness in sarcoma surgery. In this study we will determine if sarcoma labeling using NIR fluorescence probes is superior with perfusion probes or a novel affibody probe. We will also determine whether NIR fluorescence using perfusion probes or a novel affibody probe can be correlated accurately to margin thickness.

  20. EO framing flight test results (United States)

    Lareau, Andre G.


    Recon/Optical, Inc. (ROI) has pioneered the electro-optical (E-O) framing generation of sensors with the CA-260, a KS-87 form/fit camera with a wafer-scale focal plane array (FPA) containing a patented, on-chip, forward motion compensation (FMC) architecture. The technology has now matured to the state where production E-O framing cameras are form/fit replacing their former film counterparts. During this interim production phase, flight demonstrations and tests are continuing to prove that E-O framing produces high-quality imagery, is robust to various platforms and mission tactics, interoperable with existing and planned C3I architectures, affordable and available, and meets the war-fighters needs. This paper discusses flight test results of the CA-260 E-O framing sensor flown in the F-14A TARPS during September 1994. This demonstration provided some unique imagery permitting a comparison of low-light level, in-flight FMC-on versus FMC-off performance. A first-level comparison of the resulting imagery based upon predicted FMC performance and post- processing numerical analysis is presented. The results indicae that the patented FMC architecture performed as predicted, and that for low-light conditions resulting in limited SNR images, on-chip FMC can provide a significant image quality improvement over post- processing alternatives.

  1. Validation of hip joint center localization methods during gait analysis using 3D EOS imaging in typically developing and cerebral palsy children. (United States)

    Assi, Ayman; Sauret, Christophe; Massaad, Abir; Bakouny, Ziad; Pillet, Hélène; Skalli, Wafa; Ghanem, Ismat


    Localization of the hip joint center (HJC) is essential in computation of gait data. EOS low dose biplanar X-rays have been shown to be a good reference in evaluating various methods of HJC localization in adults. The aim is to evaluate predictive and functional techniques for HJC localization in typically developing (TD) and cerebral palsy (CP) children, using EOS as an image based reference. Eleven TD and 17 CP children underwent 3D gait analysis. Six HJC localization methods were evaluated in each group bilaterally: 3 predictive (Plug in Gait, Bell and Harrington) and 3 functional methods based on the star arc technique (symmetrical center of rotation estimate, center transformation technique and geometrical sphere fitting). All children then underwent EOS low dose biplanar radiographs. Pelvis, lower limbs and their corresponding external markers were reconstructed in 3D. The center of the femoral head was considered as the reference (HJCEOS). Euclidean distances between HJCs estimated by each of the 6 methods and the HJCEOS were calculated; distances were shown to be lower in predictive compared to functional methods (p<0.0001). Contrarily to findings in adults, functional methods were shown to be less accurate than predictive methods in TD and CP children, which could be mainly due to the shorter thigh segment in children. Harrington method was shown to be the most accurate in the prediction of HJC (mean error≈18mm, SD=9mm) and quasi-equivalent to the Bell method. The bias for each method was quantified, allowing its correction for an improved HJC estimation. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. 3D-modeling of the spine using EOS imaging system: Inter-reader reproducibility and reliability. (United States)

    Rehm, Johannes; Germann, Thomas; Akbar, Michael; Pepke, Wojciech; Kauczor, Hans-Ulrich; Weber, Marc-André; Spira, Daniel


    To retrospectively assess the interreader reproducibility and reliability of EOS 3D full spine reconstructions in patients with adolescent idiopathic scoliosis (AIS). 73 patients with mean age of 17 years and a moderate AIS (median Cobb Angle 18.2°) obtained low-dose standing biplanar radiographs with EOS. Two independent readers performed "full spine" 3D reconstructions of the spine with the "full-spine" method adjusting the bone contour of every thoracic and lumbar vertebra (Th1-L5). Interreader reproducibility was assessed regarding rotation of every single vertebra in the coronal (i.e. frontal), sagittal (i.e. lateral), and axial plane, T1/T12 kyphosis, T4/T12 kyphosis, L1/L5 lordosis, L1/S1 lordosis and pelvic parameters. Radiation exposure, scan-time and 3D reconstruction time were recorded. Interclass correlation (ICC) ranged between 0.83 and 0.98 for frontal vertebral rotation, between 0.94 and 0.99 for lateral vertebral rotation and between 0.51 and 0.88 for axial vertebral rotation. ICC was 0.92 for T1/T12 kyphosis, 0.95 for T4/T12 kyphosis, 0.90 for L1/L5 lordosis, 0.85 for L1/S1 lordosis, 0.97 for pelvic incidence, 0.96 for sacral slope, 0.98 for sagittal pelvic tilt and 0.94 for lateral pelvic tilt. The mean time for reconstruction was 14.9 minutes (reader 1: 14.6 minutes, reader 2: 15.2 minutes, p3D angle measurement of vertebral rotation proved to be reliable and was performed in an acceptable reconstruction time. Interreader reproducibility of axial rotation was limited to some degree in the upper and middle thoracic spine due the obtuse angulation of the pedicles and the processi spinosi in the frontal view somewhat complicating their delineation.

  3. The EducEO project (United States)

    Fritz, Steffen; Dias, Eduardo; Zeug, Guenther; Vescovi, Fabio; See, Linda; Sturn, Tobias; McCallum, Ian; Stammes, Piet; Snik, Frans; Hendriks, Elise


    The ESA funded EducEO project is aimed at demonstrating the potential of citizen science and crowdsourcing for Earth Observation (EO), where citizen science and crowdsourcing refer to the involvement of citizens in tasks such as data collection. The potential for using citizens in the calibration and validation of satellite imagery through in-situ measurements and image recognition is largely untapped. The EducEO project will aim to achieve good integration with networks such as GLOBE (primary and secondary education) and COST (higher education) to involve students in four different applications that will be piloted as part of the EducEO project. The presentation will provide a brief overview and initial results of these applications, which include: the iSpex tool for measuring air pollution using an iPhone; a game to classify cropland and deforested areas from high resolution satellite imagery; an application to monitor areas of forest change using radar data from Sentinel-1; and the collection of in-situ yield and production data from both farmers (using high-tech farming equipment) and students. In particular initial results and future potential of the serious game on land cover and forest change monitoring will be discussed.

  4. Monitoring bacterial burden, inflammation and bone damage longitudinally using optical and μCT imaging in an orthopaedic implant infection in mice.

    Directory of Open Access Journals (Sweden)

    Jared A Niska

    Full Text Available Recent advances in non-invasive optical, radiographic and μCT imaging provide an opportunity to monitor biological processes longitudinally in an anatomical context. One particularly relevant application for combining these modalities is to study orthopaedic implant infections. These infections are characterized by the formation of persistent bacterial biofilms on the implanted materials, causing inflammation, periprosthetic osteolysis, osteomyelitis, and bone damage, resulting in implant loosening and failure.An orthopaedic implant infection model was used in which a titanium Kirshner-wire was surgically placed in femurs of LysEGFP mice, which possess EGFP-fluorescent neutrophils, and a bioluminescent S. aureus strain (Xen29; 1×10(3 CFUs was inoculated in the knee joint before closure. In vivo bioluminescent, fluorescent, X-ray and μCT imaging were performed on various postoperative days. The bacterial bioluminescent signals of the S. aureus-infected mice peaked on day 19, before decreasing to a basal level of light, which remained measurable for the entire 48 day experiment. Neutrophil EGFP-fluorescent signals of the S. aureus-infected mice were statistically greater than uninfected mice on days 2 and 5, but afterwards the signals for both groups approached background levels of detection. To visualize the three-dimensional location of the bacterial infection and neutrophil infiltration, a diffuse optical tomography reconstruction algorithm was used to co-register the bioluminescent and fluorescent signals with μCT images. To quantify the anatomical bone changes on the μCT images, the outer bone volume of the distal femurs were measured using a semi-automated contour based segmentation process. The outer bone volume increased through day 48, indicating that bone damage continued during the implant infection.Bioluminescent and fluorescent optical imaging was combined with X-ray and μCT imaging to provide noninvasive and longitudinal

  5. A whole image approach using field measurements for transforming EO1 Hyperion hyperspectral data into canopy reflectance spectra (United States)

    Ramsey, Elijah W.; Nelson, G.


    To maximize the spectral distinctiveness (information) of the canopy reflectance, an atmospheric correction strategy was implemented to provide accurate estimates of the intrinsic reflectance from the Earth Observing 1 (EO1) satellite Hyperion sensor signal. In rendering the canopy reflectance, an estimate of optical depth derived from a measurement of downwelling irradiance was used to drive a radiative transfer simulation of atmospheric scattering and attenuation. During the atmospheric model simulation, the input whole-terrain background reflectance estimate was changed to minimize the differences between the model predicted and the observed canopy reflectance spectra at 34 sites. Lacking appropriate spectrally invariant scene targets, inclusion of the field and predicted comparison maximized the model accuracy and, thereby, the detail and precision in the canopy reflectance necessary to detect low percentage occurrences of invasive plants. After accounting for artifacts surrounding prominent absorption features from about 400nm to 1000nm, the atmospheric adjustment strategy correctly explained 99% of the observed canopy reflectance spectra variance. Separately, model simulation explained an average of 88%??9% of the observed variance in the visible and 98% ?? 1% in the near-infrared wavelengths. In the 34 model simulations, maximum differences between the observed and predicted reflectances were typically less than ?? 1% in the visible; however, maximum reflectance differences higher than ?? 1.6% (

  6. Normative 3D acetabular orientation measurements by the low-dose EOS imaging system in 102 asymptomatic subjects in standing position: Analyses by side, gender, pelvic incidence and reproducibility. (United States)

    Thelen, T; Thelen, P; Demezon, H; Aunoble, S; Le Huec, J-C


    Three-dimensional (3D) acetabular orientation is a fundamental topic in orthopedic surgery. Computed tomography (CT) allows 3D measurement of native acetabular orientation, but with a substantial radiation dose. The EOS imaging system was developed to perform this kind of evaluation, but has not been validated in this indication with specific attention to the acetabulum. We therefore performed a prospective study using EOS to assess: (1) the reproducibility of the 3D acetabulum orientation measures; (2) normative asymptomatic acetabular morphology in standing position, according to side and gender; and (3) the relationship between acetabular anteversion and pelvic incidence. The low-dose EOS imaging system is a reproducible method for measuring 3D acetabular orientation in standing position. In a previous prospective study of spine sagittal balance, 165 asymptomatic volunteers were examined on whole-body EOS biplanar X-ray; 102 had appropriate images for pelvic and acetabular analysis, with an equal sex-ratio (53 female, 49 male). These EOS images were reviewed using sterEOS 3D software, allowing automatic measurement of acetabular parameters (anteversion and inclination) and pelvic parameters (pelvic incidence, pelvic tilt and sacral slope) in an anatomical (anterior pelvic plane: APP) and a functional reference plane (patient vertical plane: PVP). Both intra- and inter-observer analysis showed good agreement (ICC>0.90); Bland-Altman plot distributions were good. Acetabular anatomical anteversion and inclination relative to APP (AAAPP and AIAPP, respectively) were significantly greater in women than in men, with no effect of side (right AAA: women 21.3°±3.4° vs. men 16.1°±3.3° (P62°) correlated significantly with functional acetabular orientation in standing position: PVP functional anteversion decreased by 5° relative to APP anteversion with incidence APP with incidence 44-62°, and or was greater by 4° relative to APP with incidence >62°. The use of a

  7. Building EOS capability for Malaysia - the options (United States)

    Subari, M. D.; Hassan, A.


    Earth observation satellite (EOS) is currently a major tool to monitor earth dynamics and increase human understanding of earth surface process. Since the early 80s, Malaysia has been using EOS images for various applications, such as weather forecasting, land use mapping, agriculture, environment monitoring and others. Until now, all EOS images were obtained from foreign satellite systems. Realising on the strategic need of having its own capability, Malaysia embarked into EOS development programs in the early 90s. Starting with TiungSAT-1, a micro-satellite carrying small camera, then followed by RazakSAT, a small satellite carrying 2.5 m panchromatic (PAN) medium-aperture-camera, the current satellite program development, the RazakSAT-2, designed to carry a 1.0 m high resolution PAN and 4.0m multi-spectral camera, would become a strategic initiative of the government in developing and accelerating the nation's capability in the area of satellite technology and its application. Would this effort continue until all needs of the remote sensing community being fulfilled by its own EOS? This paper will analyze the intention of the Malaysian government through its National Space Policy and other related policy documents, and proposes some policy options on this. Key factors to be considered are specific data need of the EOS community, data availability and the more subjective political motivations such as national pride.

  8. A Visual Database System for Image Analysis on Parallel Computers and its Application to the EOS Amazon Project (United States)

    Shapiro, Linda G.; Tanimoto, Steven L.; Ahrens, James P.


    The goal of this task was to create a design and prototype implementation of a database environment that is particular suited for handling the image, vision and scientific data associated with the NASA's EOC Amazon project. The focus was on a data model and query facilities that are designed to execute efficiently on parallel computers. A key feature of the environment is an interface which allows a scientist to specify high-level directives about how query execution should occur.

  9. Attempt to find optimal selections of EO systems for good results of imaging in real environment surveillance process (United States)

    Borcan, Octavia; Ursu, Danut; Marin, Constantin; Toma, Alexandru; Beldiceanu, Anca


    In this paper, the authors try to determine a procedure for the best choice in selecting one or other type of sensors as a function of the object under observation, background and environmental conditions. In surveillance activities related with different missions and scenarios occurred in day and/or night time, the proper choice and use of video surveillance sensors is of huge importance. Starting from specific scenarios of surveillance, as for example the surveillance of the sky to detect drones, or surveillance of the ground area to detect some manmade objects or intruders, this paper approaches the problem of the image appearance in VIS, SWIR and LWIR spectral ranges, using different passive technologies of surveillance. Relevant images are comparative presented in relation with some theoretical quantifications made through mathematical models or through software simulations. Starting from a few targets and backgrounds with known spectral reflectivity or emissivity, the contrast was used to show its influence on the signal strength reaching the surface of the video detector (imager) in similar environment conditions. Finally, the authors seek certain characteristics of the electro-optical system itself that can influence most the strength and quality of the optical signal with respect to influences on observation distances of the target. The possibility of using an active technology instead of a passive one, by introducing a pulsed laser illuminator, is also analyzed. The use of some polarizing filters is also considered but in this stage only in laboratory conditions, in order to improve the observability of an object in some special environmental circumstances.

  10. East African Orthopaedic Journal

    African Journals Online (AJOL)

    The aim of the journal is to give orthopaedic surgeons, technologists and other personnel within the orthopaedic specialty a forum of diverging their research findings to the rest of the world. We publish original research papers, case reports, reviews and commentaries.

  11. EOS Aura Mission Status (United States)

    Guit, William J.


    This PowerPoint presentation will discuss EOS Aura mission and spacecraft subsystem summary, recent and planned activities, inclination adjust maneuvers, propellant usage lifetime estimate. Eric Moyer, ESMO Deputy Project Manager-Technical (code 428) has reviewed and approved the slides on April 30, 2015.

  12. PVT modeling of reservoir fluids using PC-SAFT EoS and Soave-BWR EoS

    DEFF Research Database (Denmark)

    Yan, Wei; Varzandeh, Farhad; Stenby, Erling Halfdan


    Cubic equations of state, such as the Soave-Redlich-Kwong (SRK) and the Peng-Robinson (PR) EoS, are still the mostly used models in PVT modeling of reservoir fluids, and almost the exclusively used models in compositional reservoir simulations. Nevertheless, it is promising that recently developed...... non-cubic EoS models, such as the Perturbed Chain Statistical Associating Fluid Theory (PC-SAFT) EoS and the Soave modified Benedict-Webb-Rubin (Soave-BWR) EoS, may partly replace the roles of these classical cubic models in the upstream oil industry. Here, we attempt to make a comparative study...... of non-cubic models (PC-SAFT and Soave-BWR) and cubic models (SRK and PR) in several important aspects related to PVT modeling of reservoir fluids, including density description for typical pure components in reservoir fluids, description of binary VLE, prediction of multicomponent phase envelopes...

  13. Orthopaedics in day surgery

    African Journals Online (AJOL)

    emergency patients for a surgical procedure, returning home the same day (1). Ambulatory orthopaedics happens to have double meaning, so in this communication day surgery will be the preferred term. In Kenya the three models of day.

  14. Scaling the EOS namespace

    CERN Document Server

    Peters, Andreas J; Bitzes, Georgios


    EOS is the distributed storage system being developed at CERN with the aim of fulfilling a wide range of data storage needs, ranging from physics data to user home directories. Being in production since 2011, EOS currently manages around 224 petabytes of disk space and 1.4 billion files across several instances. Even though individual EOS instances routinely manage hundreds of disk servers, users access the contents through a single, unified namespace which is exposed by the head node (MGM), and contains the metadata of all files stored on that instance. The legacy implementation keeps the entire namespace in-memory. Modifications are appended to a persistent, on-disk changelog; this way, the in-memory contents can be reconstructed after every reboot by replaying the changelog. While this solution has proven reliable and effective, we are quickly approaching the limits of its scalability. In this paper, we present our new implementation which is currently in testing. We have designed and implemented QuarkD...

  15. Electrical overstress (EOS) devices, circuits and systems

    CERN Document Server

    Voldman, Steven H


    Electrical Overstress (EOS) continues to impact semiconductor manufacturing, semiconductor components and systems as technologies scale from micro- to nano-electronics.  This bookteaches the fundamentals of electrical overstress  and how to minimize and mitigate EOS failures. The text provides a clear picture of EOS phenomena, EOS origins, EOS sources, EOS physics, EOS failure mechanisms, and EOS on-chip and system design.  It provides an illuminating insight into the sources of EOS in manufacturing, integration of on-chip, and system level EOS protection networks, followed by examples in spe

  16. Orthopaedic training in Kenya

    African Journals Online (AJOL)

    Background: Orthopaedic training in Kenya, like in other East, central and southern Africa college of surgeons (cOsEcsA) countries is varied leading to specialists with varying exposures and competencies. the experience in Kenya is used here to study the problem, point out the shortcomings and suggest possible remedies ...

  17. [Orthopaedics' megalomania - myth or mobbing? (United States)

    Gundtoft, Per Hviid; Brand, Eske; Klit, Jakob; Weisskirchner, Kristoffer Barfod


    It is a general impression in the world of medicine that orthopaedic surgeons differ from doctors of other specialities in terms of intellect and self-confidence. The purpose of this study was to evaluate the self-confidence of orthopaedics. We asked doctors from 30 different specialities to fill out a questionnaire. In addition to this, the participating orthopaedics were asked to rate their self-perceived surgical skills. In all, 120 orthopaedics and 416 non-orthopaedic doctors completed the questionnaire. There was no difference in GSE scores between orthopaedics and other doctors (p = 0.58). 98% of young orthopaedics estimated that their surgical talent was average or above average when compared with their colleagues on the same level of education. 72% believed that they were "equally talented", "more talented", or "far more talented" than their colleagues on a higher level of education. 76% believed that when assisting a senior surgeon the patients would "sometimes" (60%), "often" (14%) or "always" (2%) be better off if they were the ones performing the operation. More orthopaedics than non-orthopaedics believed that their speciality was regarded as one of the least important specialities in the world of medicine (p = 0.001). Orthopaedic surgeons in general are not more self-confident than other doctors or the average population, but young orthopaedic surgeons have a very high level of confidence in their own operation skills. none. none.

  18. Orthopaedic Management of Spasticity. (United States)

    Pidgeon, Tyler S; Ramirez, Jose M; Schiller, Jonathan R


    Spasticity is a common manifestation of many neurological conditions including multiple sclerosis, stroke, cerebral palsy, traumatic brain injury, and spinal cord injuries. Management of spasticity seeks to reduce its burden on patients and to limit secondary complications. Non-operative interventions including stretching/splinting, postural management, physical therapy/strengthening, anti-spasticity medications, and botulinum toxin injections may help patients with spasticity. Surgical management of these conditions, however, is often necessary to improve quality of life and prevent complications. Orthopaedic surgeons manage numerous sequelae of spasticity, including joint contractures, hip dislocations, scoliosis, and deformed extremities. When combined with the efforts of rehabilitation specialists, neurologists, and physical/occupational therapists, the orthopaedic management of spasticity can help patients maintain and regain function and independence as well as reduce the risk of long-tem complications.

  19. Biomaterials in orthopaedics (United States)

    Navarro, M; Michiardi, A; Castaño, O; Planell, J.A


    At present, strong requirements in orthopaedics are still to be met, both in bone and joint substitution and in the repair and regeneration of bone defects. In this framework, tremendous advances in the biomaterials field have been made in the last 50 years where materials intended for biomedical purposes have evolved through three different generations, namely first generation (bioinert materials), second generation (bioactive and biodegradable materials) and third generation (materials designed to stimulate specific responses at the molecular level). In this review, the evolution of different metals, ceramics and polymers most commonly used in orthopaedic applications is discussed, as well as the different approaches used to fulfil the challenges faced by this medical field. PMID:18667387

  20. HDF-EOS Web Server (United States)

    Ullman, Richard; Bane, Bob; Yang, Jingli


    A shell script has been written as a means of automatically making HDF-EOS-formatted data sets available via the World Wide Web. ("HDF-EOS" and variants thereof are defined in the first of the two immediately preceding articles.) The shell script chains together some software tools developed by the Data Usability Group at Goddard Space Flight Center to perform the following actions: Extract metadata in Object Definition Language (ODL) from an HDF-EOS file, Convert the metadata from ODL to Extensible Markup Language (XML), Reformat the XML metadata into human-readable Hypertext Markup Language (HTML), Publish the HTML metadata and the original HDF-EOS file to a Web server and an Open-source Project for a Network Data Access Protocol (OPeN-DAP) server computer, and Reformat the XML metadata and submit the resulting file to the EOS Clearinghouse, which is a Web-based metadata clearinghouse that facilitates searching for, and exchange of, Earth-Science data.

  1. Determining the Equation of State (EoS) Parameters for Ballistic Gelatin (United States)


    ARL-TR-7467 ● SEP 2015 US Army Research Laboratory Determining the Equation of State (EoS) Parameters for Ballistic Gelatin ...EoS) Parameters for Ballistic Gelatin by Yolin Huang Weapons and Materials Research Directorate, ARL Approved for...State (EoS) Parameters for Ballistic Gelatin 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Yolin Huang 5d

  2. Citation classics in pediatric orthopaedics. (United States)

    Varghese, Ranjit A; Dhawale, Arjun A; Zavaglia, Bogard C; Slobogean, Bronwyn L; Mulpuri, Kishore


    The purpose of this study was to identify the clinical pediatric orthopaedic articles with at least 100 citations published in all orthopaedic journals and to examine their characteristics. All journals dedicated to orthopaedics and its subspecialties were selected from the Journal Citation Report 2001 under the subject category "orthopedics." Articles cited 100 times or more were identified using the database of the Science Citation Index Expanded (SCI-EXPANDED, 1900 to present). The articles were ranked in a comprehensive list. Two authors independently reviewed the full text of each article and applied the inclusion and exclusion criteria to the list of articles. The 2 lists were then compared. All disagreements were resolved by consensus with input from the senior author. The final list of pediatric orthopaedic articles was then compiled. There were a total of 49 journals under the search category "orthopedics." Five journals were excluded as they were non-English journals. The remaining 44 journals were screened for articles with at least 100 citations. A total of 135 clinical pediatric orthopaedic articles cited at least 100 times were included. The most cited article was cited 692 times. The mean number of citations per article was 159 (95% confidence interval, 145-173). All the articles were published between 1949 and 2001, with 1980 and 1989 producing the most citation classics (34). The majority (90) originated from the United States, followed by the United Kingdom (12) and Canada (11). Scoliosis/kyphosis was the most common topic with 26 papers. The second most common subject was hip disorders (24). Therapeutic studies were the most common study type (71). Ninety-seven papers were assigned a 4 for level of evidence. The list of citation classics in pediatric orthopaedic articles is useful for several reasons. It identifies important contributions to the field of pediatric orthopaedics and their originators; it facilitates the understanding and discourse

  3. babatunde, ro and boluwade, eo

    African Journals Online (AJOL)

    BABATUNDE, R.O AND BOLUWADE, E.O. ABSTRACT. This study was designed to examine resource use efficiency in food crop production in Ekiti State of Nigeria. Primary data were collected from 110 food crop farmers selected using multi-stage random sampling technique. Data analysis was done using both inferential ...

  4. Lidar instruments proposed for Eos (United States)

    Grant, William B.; Browell, Edward V.


    Lidar, an acronym for light detection and ranging, represents a class of instruments that utilize lasers to send probe beams into the atmosphere or onto the surface of the Earth and detect the backscattered return in order to measure properties of the atmosphere or surface. The associated technology has matured to the point where two lidar facilities, Geodynamics Laser Ranging System (GLRS), and Laser Atmospheric Wind Sensor (LAWS) were accepted for Phase 2 studies for Eos. A third lidar facility Laser Atmospheric Sounder and Altimeter (LASA), with the lidar experiment EAGLE (Eos Atmospheric Global Lidar Experiment) was proposed for Eos. The generic lidar system has a number of components. They include controlling electronics, laser transmitters, collimating optics, a receiving telescope, spectral filters, detectors, signal chain electronics, and a data system. Lidar systems that measure atmospheric constituents or meteorological parameters record the signal versus time as the beam propagates through the atmosphere. The backscatter arises from molecular (Rayleigh) and aerosol (Mie) scattering, while attenuation arises from molecular and aerosol scattering and absorption. Lidar systems that measure distance to the Earth's surface or retroreflectors in a ranging mode record signals with high temporal resolution over a short time period. The overall characteristics and measurements objectives of the three lidar systems proposed for Eos are given.

  5. On Application of Non-cubic EoS to Compositional Reservoir Simulation

    DEFF Research Database (Denmark)

    Yan, Wei; Michelsen, Michael Locht; Stenby, Erling Halfdan

    Compositional reservoir simulation uses almost exclusively cubic equations of state (EoS) such as the SRK EoS and the PR EoS. This is in contrast with process simulation in the downstream industry where more recent and advanced thermodynamic models are quickly adopted. Many of these models are non-cubic...... EoS, such as the PC-SAFT EoS. A major reason for the use of the conventional cubic EoS in reservoir simulation is the concern over computation time. Flash computation is the most time consuming part in compositional reservoir simulation, and the extra complexity of the non-cubic EoS may significantly...... increase the time consumption. In addition to this, the non-cubic EoS also needs a C7+ characterization. The main advantage of the non-cubic EoS is that it provides for a more accurate descrition of fluid properties, and it is therefore of interest to investigate the computational aspects of using...

  6. Microscopic EoS for High Density Matter

    International Nuclear Information System (INIS)

    Stone, J. R.


    The density and temperature dependence of energy per particle of a system (the Equation of State--EoS) is a fundamental ingredient of all models of nuclear matter and stars. As baryons and leptons form the main components of all stars, knowledge of nuclear physics and weak interactions is essential for correct understanding of the birth, life and death of stars. We compare results obtained with EOS's based on a selection of well established nucleon-nucleon effective interactions with new results from the quark-meson coupling model and the Oxford quark model based effective potential. Properties of cold non-rotating neutron stars, calculated on the basis of the models, are presented and discussed.

  7. American Academy of Orthopaedic Surgeons (United States)

    ... Opportunities Research Advocacy Research Capitol Hill Days Extremity War Injuries Regulatory Science Biological Implants Biomedical Engineering Orthopaedic Device Forum Advocacy Federal Advocacy Ancillary Services Drugs, Devices, and FDA Health Information Technology Medical Liability ...

  8. Auditing orthopaedic audit. (United States)

    Guryel, E; Acton, K; Patel, S


    Clinical audit plays an important role in the drive to improve the quality of patient care and thus forms a cornerstone of clinical governance. Assurance that the quality of patient care has improved requires completion of the audit cycle. A considerable sum of money and time has been spent establishing audit activity in the UK. Failure to close the loop undermines the effectiveness of the audit process and wastes resources. We analysed the effectiveness of audit in trauma and orthopaedics at a local hospital by comparing audit projects completed over a 6-year period to criteria set out in the NHS National Audit and Governance report. Of the 25 audits performed since 1999, half were presented to the relevant parties and only 20% completed the audit cycle. Only two of these were audits against national standards and 28% were not based on any standards at all. Only a third of the audits led by junior doctors resulted in implementation of their action plan compared to 75% implementation for consultant-led and 67% for nurse-led audits. A remarkably large proportion of audits included in this analysis failed to meet accepted criteria for effective audit. Audits completed by junior doctors were found to be the least likely to complete the cycle. This may relate to the lack of continuity in modern medical training and little incentive to complete the cycle. Supervision by permanent medical staff, principally consultants, and involvement of the audit department may play the biggest role in improving implementation of change.

  9. Science Quality Assessment in Support of EOS MISR Data (United States)

    Lewicki, S.; Crean, K.; Kahn, R.


    The Multi-angle Imaging SpectroRadiometer (MISR) instrument, scheduled to fly on board the first Earth Observing System (EOS) spacecraft, will have a data stream that produces over 100 GB of data per day, once in full operation, of information about the Earth's atmosphere, clouds, and surface.

  10. Science synergism study for EOS on evolution of desert surfaces (United States)

    Farr, Tom G.


    The effectiveness of EOS data as a basis for the study of desert surfaces' evolution is presently evaluated for both long and short term geomorphic evolution. Attention is given to the usefulness of such sensor systems planned for EOS as MODIS for regional vegetation distribution/variability monitoring, HIRIS for visible-near IR observations, TIMS for lithological identification, HMMR and SSMI for soil characteristics, LASA for atmospheric profiles, SAR for surface roughness, ALT for two-dimensional topography, ACR for the calibration of imaging sensors, and ERBE for climate modeling and regional surface albedo variation determinations.

  11. Earth Observing System (EOS) advanced altimetry (United States)

    Parsons, C. L.; Walsh, E. J.


    In the post-TOPEX era, satellite radar altimeters will be developed with the capability of measuring the earth's surface topography over a wide swath of coverage, rather than just at the satellite's nadir. The identification of potential spacecraft flight missions in the future was studied. The best opportunity was found to be the Earth Observing System (EOS). It is felt that an instrument system that has a broad appeal to the earth sciences community stands a much better chance of being selected as an EOS instrument. Consequently, the Topography and Rain Radar Imager (TARRI) will be proposed as a system that has the capability to profile the Earth's topography regardless of the surface type. The horizontal and height resolutions of interest are obviously significantly different over land, ice, and water; but, the use of radar to provide an all-weather observation capability is applicable to the whole earth. The scientific guidance for the design and development of this instrument and the eventual scientific utilization of the data produced by the TARRI will be provided by seven science teams. The teams are formed around scientific disciplines and are titled: Geology/Geophysics, Hydrology/Rain, Oceanography, Ice/Snow, Geodesy/Orbit/Attitude, Cartography, and Surface Properties/Techniques.

  12. Advancing Glaciological Applications of Remote Sensing with EO-1: (1) Mapping Snow Grain Size and Albedo on the Greenland Ice Sheet Using an Imaging Spectrometer, and (2) ALI Evaluation for Subtle Surface Topographic Mapping via Shape-from Shading (United States)


    The Hyperion sensor, onboard NASA's Earth Observing-1 (EO-1) satellite,is an imaging spectroradiometer with 220 spectral bands over the spectral range from 0.4 - 2.5 microns. Over the course of summer 2001, the instrument acquired numerous images over the Greenland ice sheet. Our main motivation is to develop an accurate and robust approach for measuring the broadband albedo of snow from satellites. Satellite-derived estimates of broadband have typically been plagued with three problems: errors resulting from inaccurate atmospheric correction, particularly in the visible wavelengths from the conversion of reflectance to albedo (accounting for snow BRDE); and errors resulting from regression-based approaches used to convert narrowband albedo to broadband albedo. A typerspectral method has been developed that substantially reduces these three main sources of error and produces highly accurate estimates of snow albedo. This technique uses hyperspectral data from 0.98 - 1.06 microns, spanning a spectral absorption feature centered at 1.03 microns. A key aspect of this work is that this spectral range is within an atmospheric transmission window and reflectances are largely unaffected by atmospheric aerosols, water vapor, or ozone. In this investigation, we make broadband albedo measurements at four sites on the Greenland ice sheet: Summit, a high altitude station in central Greenland; the ETH/CU camp, a camp on the equilibrium line in western Greenland; Crawford Point, a site located between Summit and the ETH/CU camp; and Tunu, a site located in northeastern Greenland at 2000 m. altitude. Each of these sites has an automated weather station (AWS) that continually measures broadband albedo thereby providing validation data.

  13. American Orthopaedic Foot and Ankle Society (United States)

    ... IFFAS / AOFAS eBook ​The AOFAS and MD Conference Express invite you to enjoy complimentary access to the ... Foundation Exhibit Privacy Statement Legal Disclosure Site Map American Orthopaedic Foot & Ankle Society ® Orthopaedic Foot & Ankle Foundation ...

  14. Developmental orthopaedic diseases in foals

    International Nuclear Information System (INIS)

    Şİrİn, Özlem; Alkan, Zeki


    Developmental Orthopaedic Diseases (DOD) is seen frequently in horses which completed their maturity. Osteochondrosis, physitis, angular limb deformities, flexural deformities, juvenil arthritis, cervical vertebral anomalies, cuboidal bone abnormalities are problems investigated under Developmental Orthopaedic Diseases title. This diseases can develop single or some together in fast growing, heavy animals (especially Arabian and English Thoroughbreds). Multifactorial causes of this diseases etiopathogenesis can be listed as genetic predisposition, trauma, nutrition, vitamins/minerals and endocrine disorders. But the exact causes of these diseases are not known. In this review detailed information are given about the diseases mentioned above

  15. Orthopaedic training in Kenya | Mulimba | East African Orthopaedic ...

    African Journals Online (AJOL)

    Objective: To do a survey of the current orthopaedic specialists in Kenya's training since their first medical degrees. Determine the duration, facilities and methods of training. Methods: A number of doctors trained under different arrangements were identified, interviewed and where curriculum was available this was read.

  16. Patient compliance and effect of orthopaedic shoes

    DEFF Research Database (Denmark)

    Philipsen, A B; Ellitsgaard, N; Krogsgaard, M R


    Orthopaedic shoes are individually handmade after a prescription from an orthopaedic surgeon, hence relatively expensive. Bad compliance is mentioned in the literature but not investigated. In order to evaluate patient compliance and the effect of orthopaedic shoes, 85 patients who were prescribed...

  17. Do Orthopaedic Surgeons Acknowledge Uncertainty?

    NARCIS (Netherlands)

    Teunis, Teun; Janssen, Stein; Guitton, Thierry G.; Ring, David; Parisien, Robert


    Much of the decision-making in orthopaedics rests on uncertain evidence. Uncertainty is therefore part of our normal daily practice, and yet physician uncertainty regarding treatment could diminish patients' health. It is not known if physician uncertainty is a function of the evidence alone or if

  18. Galileo's contribution to modern orthopaedics. (United States)

    Jastifer, James R; Toledo-Pereyra, Luis H; Gustafson, Peter A


    Galileo Galilei (1564-1642), world-renowned Italian mathematician, astronomer, physicist and philosopher, made many contributions to science. The objective of this study is to demonstrate that Galileo's discovery of scaling principles permitted others to define and advance orthopaedic research and clinical sciences. The science and scaling principles of Galileo Galilei were extensively analyzed by reviewing his 1638 original work Discorsi e Demostrazioni Matematiche Intorno a Due Nuove Scienze. Works about Galileo's science were reviewed for the concept of the scaling principles and with the idea of shedding light on how his work influenced modern orthopaedics. Galileo strictly adhered to the Copernican heliocentric theory with the sun at the center of the universe, which caused him aggravation and made him the target of inquisition rage at the end of his prodigious life. With his attention away from the cosmos, Galileo--through the voices of Salviati, Sagredo and Simplicio in the Discourses on Two New Sciences--defined how scaling was important to the movement and function of objects. Galileo introduced important advances in scaling laws, which contributed to the development of the field of biomechanics. This discipline, in many ways, has defined modern clinical and research orthopaedics. Galileo, by introducing the principles of scaling, permitted their application to human physical capacity, to bone and tissue response after injury, and to clinical treatment of injuries. Galileo in this way made important contributions to the practice of modern orthopaedics.

  19. Hand dominance in orthopaedic surgeons.

    LENUS (Irish Health Repository)

    Lui, Darren F


    Handedness is perhaps the most studied human asymmetry. Laterality is the preference shown for one side and it has been studied in many aspects of medicine. Studies have shown that some orthopaedic procedures had poorer outcomes and identified laterality as a contributing factor. We developed a questionnaire to assess laterality in orthopaedic surgery and compared this to an established scoring system. Sixty-two orthopaedic surgeons surveyed with the validated Waterloo Handedness Questionnaire (WHQ) were compared with the self developed Orthopaedic Handedness Questionnaire (OHQ). Fifty-eight were found to be right hand dominant (RHD) and 4 left hand dominant (LHD). In RHD surgeons, the average WHQ score was 44.9% and OHQ 15%. For LHD surgeons the WHQ score was 30.2% and OHQ 9.4%. This represents a significant amount of time using the non dominant hand but does not necessarily determine satisfactory or successful dexterity transferable to the operating room. Training may be required for the non dominant side.

  20. Limited Range Sesame EOS for Ta

    Energy Technology Data Exchange (ETDEWEB)

    Greeff, Carl William [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Crockett, Scott [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Rudin, Sven Peter [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Burakovsky, Leonid [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)


    A new Sesame EOS table for Ta has been released for testing. It is a limited range table covering T ≤ 26, 000 K and ρ ≤ 37.53 g/cc. The EOS is based on earlier analysis using DFT phonon calculations to infer the cold pressure from the Hugoniot. The cold curve has been extended into compression using new DFT calculations. The present EOS covers expansion into the gas phase. It is a multi-phase EOS with distinct liquid and solid phases. A cold shear modulus table (431) is included. This is based on an analytic interpolation of DFT calculations.

  1. Communication skills training in orthopaedics. (United States)

    Lundine, Kristopher; Buckley, Richard; Hutchison, Carol; Lockyer, Jocelyn


    Communication skills play a key role in many aspects of both medical education and clinical patient care. The objectives of this study were to identify the key components of communication skills from the perspectives of both orthopaedic residents and their program directors and to understand how these skills are currently taught. This study utilized a mixed methods design. Quantitative data were collected with use of a thirty-item questionnaire distributed to all Canadian orthopaedic residents. Qualitative data were collected through focus groups with orthopaedic residents and semistructured interviews with orthopaedic program directors. One hundred and nineteen (37%) of 325 questionnaires were completed, twelve residents participated in two focus groups, and nine of sixteen program directors from across the country were interviewed. Both program directors and residents identified communication skills as being the accurate and appropriate use of language (i.e., content skills), not how the communication was presented (i.e., process skills). Perceived barriers to effective communication included time constraints and the need to adapt to the many personalities and types of people encountered daily in the hospital. Residents rarely have explicit training in communication skills. They rely on communication training implicitly taught through observation of their preceptors and clinical experience interacting with patients, peers, and other health-care professionals. Orthopaedic residents and program directors focus on content and flexibility within communication skills as well as on the importance of being concise. They value the development of communication skills in the clinical environment through experiential learning and role modeling. Education should focus on developing residents' process skills in communication. Care should be taken to avoid large-group didactic teaching sessions, which are perceived as ineffective.

  2. Earth Observing System (EOS) Advanced Microwave Sounding Unit-A2 (EOS/AMSU-A): EOS Software Test Report (United States)


    This document describes the results of the formal qualification test (FQT)/ Demonstration conducted on September 10, and 14, 1998 for the EOS AMSU-A2 instrument. The purpose of the report is to relate the results of the functional performance and interface tests of the software. This is the final submittal of the EOS/AMSU-A Software Test report.

  3. Cartilage hair hypoplasia: characteristics and orthopaedic manifestations. (United States)

    Riley, Patrick; Weiner, Dennis S; Leighley, Bonnie; Jonah, David; Morton, D Holmes; Strauss, Kevin A; Bober, Michael B; Dicintio, Martin S


    Cartilage hair hypoplasia (CHH) is a rare metaphyseal chondrodysplasia characterized by short stature and short limbs, found primarily in Amish and Finnish populations. Cartilage hair hypoplasia is caused by mutations in the RMRP gene located on chromosome 9p13.3. The disorder has several characteristic orthopaedic manifestations, including joint laxity, limited elbow extension, ankle varus, and genu varum. Immunodeficiency is of concern in most cases. Although patients exhibit orthopaedic problems, the orthopaedic literature on CHH patients is scant at best. The objective of this study was to characterize the orthopaedic manifestations of CHH based on the authors' unique access to the largest collection of CHH patients ever reported. The authors examined charts and/or radiographs in 135 cases of CHH. We analyzed the orthopaedic manifestations to better characterize and further understand the orthopaedic surgeon's role in this disorder. In addition to describing the clinical characteristics, we report on our surgical experience in caring for CHH patients. Genu varum, with or without knee pain, is the most common reason a patient with CHH will seek orthopaedic consultation. Of the cases reviewed, 32 patients had undergone surgery, most commonly to correct genu varum. This paper characterizes the orthopaedic manifestations of CHH. Characterizing this condition in the orthopaedic literature will likely assist orthopaedic surgeons in establishing a correct diagnosis and appreciating the orthopaedic manifestations. It is important that the accompanying medical conditions are appreciated and evaluated.

  4. Planning for life after orthopaedics. (United States)

    Barr, Joseph S; McCaslin, Michael J; Hinds, Cynthia K


    The word retirement is going out of fashion. Many orthopaedic surgeons want to work in some capacity when they stop performing surgery. Making a smooth transition from a busy orthopaedic practice to alternative work demands advanced planning. The surgeon must consider personal issues that involve how to use human capital (his or her accumulated knowledge and experience). New ventures, hobbies, travel, and spending time with family and friends are some possibilities. Plans for slowing down or leaving the practice should be discussed and agreed on well ahead of time. Agreements for buyouts may be difficult to work out and will require creative thinking. The solo practitioner can close the practice or hire a successor. Financial planning is perhaps the most important consideration and should be started by approximately age 40. It is recommended that the surgeon develop a portfolio of secure investments and annuities to provide adequate income for as long as is needed and then to turn the residual income to one's family, favorite charities, or other desired cause. A team of competent advisors is needed to help develop and achieve one's goals, create financial security, and provide the discipline to carry out the needed planning for life after orthopaedics.

  5. Social Media in Pediatric Orthopaedics. (United States)

    Lander, Sarah T; Sanders, James O; Cook, Peter C; O'Malley, Natasha T

    Internet searches and social media utilization in health care has exploded over the past 5 years, and patients utilize it to gain information on their health conditions and physicians. Social media has the potential to serve as a means for education, communication, and marketing in all health care specialties. Physicians are sometimes reluctant to engage because of concerns of privacy, litigation, and lack of experience with this modality. Many surgical subspecialties have capitalized on social media but no study to date has examined the specific footprint of pediatric orthopaedic surgeons in this realm. We aim to quantify the utilization of individual social media platforms by pediatric orthopaedic surgeons, and identify any differences between private and hospital-based physicians, but also regional differences. Using the Pediatric Orthopaedic Society of North America Member Directory, each active member's social media presence was reviewed through an Internet search. Members were stratified on the basis of practice model and geographic location. Individual Internet searches, social media sites, and number of publications were reviewed for social media presence. Of 987 Pediatric Orthopaedic Society of North America members, 95% had a professional webpage, 14.8% a professional Facebook page, 2.2% a professional Twitter page, 36.8% a LinkedIn profile, 25.8% a ResearchGate profile, 33% at least 1 YouTube. Hospital-based physicians had a lower mean level of utilization of social media compared with their private practice peers, and a higher incidence of Pubmed publications. Private practice physicians had double the social media utilization. Regional differences reveal that practicing Pediatric Orthopaedists in the Northeast had increased utilization of ResearchGate and LinkedIn and the West had the lowest mean social media utilization levels. The rapid expansion of social media usage by patients and their family members is an undeniable force affecting the health

  6. Infections in orthopaedic surgery : clinical and experimental studies


    Vogely, Henri Charles


    The diagnostic difficulties, variability in outcome and the heterogeinity of the problem of orthopaedic infections stimulated the author to a study of the literature, and several clinical and experimental studies. The diagnosis prosthesis-related infection can only be reached with an acceptable degree of certainty by combination of clinical, laboratory and imaging investigations. Fourty-seven patients with a prosthetic hip infection treated in our hospital were retrospectively divided into th...

  7. EO2HEAVEN: mitigating environmental health risks

    CSIR Research Space (South Africa)

    Le Rouw, Wouter J


    Full Text Available EO2HEAVEN has the primary objective to contribute to a better understanding of the complex relationships between environmental changes and their impact on human health. To achieve this, the project followed a multidisciplinary and user...

  8. EOS Terra: Mission Status Constellation MOWG (United States)

    Mantziaras, Dimitrios


    This EOS Terra Mission Status Constellation MOWG will discuss mission summary; spacecraft subsystems summary, recent and planned activities; inclination adjust maneuvers, conjunction history, propellant usage and lifetime estimate; and end of mission plan.

  9. Do JCZ and BKW EOS need modification? (United States)

    Roth, Julius


    The JCZ and BKW EOS are widely used to compute P-V-T relationships of the gaseous products of CJ detonations, but these computations need experimental verification. Quantitative comparisons of computed and experimental CJ parameters over a wide range of initial density ρ0 are a good test of the validity of the above EOS. Particularly useful for such comparisons are two empirical linear functions: D=A+Bρ0 and ρCJ=a+bρ0, and the adiabatic exponent κ1 for the CJ state. Reliable measured values of A and B exist for many explosives. Our previous publications obtained a, b, and κ1 based on experimental D's and selected experimental PCJ. Agreement among EOS computed and experimental values of A or B is unsatisfactory. This means that EOS-based Bρ0/D, a critical factor in obtaining the CJ Grüneisen coefficient, Jones α, and partial derivatives of many CJ variables can be in error. Computations of a or b by variants of JCZ or BKW EOS differ from the empirical a and b. Consequently, EOS-based κ1's, PCJ's, and many CJ parameters that depend on κ1 may be in error.

  10. The Core Competencies for General Orthopaedic Surgeons. (United States)

    Kellam, James F; Archibald, Douglas; Barber, James W; Christian, Eugene P; D'Ascoli, Richard J; Haynes, Richard J; Hecht, Suzanne S; Hurwitz, Shepard R; Kellam, James F; McLaren, Alexander C; Peabody, Terrance D; Southworth, Stephen R; Strauss, Robert W; Wadey, Veronica M R


    With the changing delivery of orthopaedic surgical care, there is a need to define the knowledge and competencies that are expected of an orthopaedist providing general and/or acute orthopaedic care. This article provides a proposal for the knowledge and competencies needed for an orthopaedist to practice general and/or acute care orthopaedic surgery. Using the modified Delphi method, the General Orthopaedic Competency Task Force consisting of stakeholders associated with general orthopaedic practice has proposed the core knowledge and competencies that should be maintained by orthopaedists who practice emergency and general orthopaedic surgery. For relevancy to clinical practice, 2 basic sets of competencies were established. The assessment competencies pertain to the general knowledge needed to evaluate, investigate, and determine an overall management plan. The management competencies are generally procedural in nature and are divided into 2 groups. For the Management 1 group, the orthopaedist should be competent to provide definitive care including assessment, investigation, initial or emergency care, operative or nonoperative care, and follow-up. For the Management 2 group, the orthopaedist should be competent to assess, investigate, and commence timely non-emergency or emergency care and then either transfer the patient to the appropriate subspecialist's care or provide definitive care based on the urgency of care, exceptional practice circumstance, or individual's higher training. This may include some higher-level procedures usually performed by a subspecialist, but are consistent with one's practice based on experience, practice environment, and/or specialty interest. These competencies are the first step in defining the practice of general orthopaedic surgery including acute orthopaedic care. Further validation and discussion among educators, general orthopaedic surgeons, and subspecialists will ensure that these are relevant to clinical practice. These

  11. International Combined Orthopaedic Research Societies: A model for international collaboration to promote orthopaedic and musculoskeletal research

    Directory of Open Access Journals (Sweden)

    Theodore Miclau


    Full Text Available In October 2013, the International Combined Orthopaedic Research Societies (ICORS; was founded with inaugural member organisations from the previous Combined Orthopaedic Research Society, which had sponsored combined meetings for more than 2 decades. The ICORS is dedicated to the stimulation of orthopaedic and musculoskeletal research in fields such as biomedical engineering, biology, chemistry, and veterinary and human clinical research. The ICORS seeks to facilitate communication with member organisations to enhance international research collaborations and to promote the development of new international orthopaedic and musculoskeletal research organisations. Through new categories of membership, the ICORS represents the broadest coalition of orthopaedic research organisations globally.

  12. Mentorship in orthopaedic and trauma residency training ...

    African Journals Online (AJOL)

    Background: Mentorship is important in residency training as it is necessary for personal and professional development of the resident trainees. Objectives: This study documents mentorship in orthopaedic residency training programme in Nigeria by assessing the awareness of orthopaedic residents on the role of a mentor, ...

  13. Nigerian Journal of Orthopaedics and Trauma

    African Journals Online (AJOL)

    The Nigerian Journal of Orthopaedics and Trauma publishes original papers, review articles and case reports on pathology, anaesthesia, orthopaedics and trauma. Vol 12, No 1 (2013). DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT Subscription or Fee Access. Table of Contents. Articles. Management of ...

  14. Archives: Nigerian Journal of Orthopaedics and Trauma

    African Journals Online (AJOL)

    Items 1 - 19 of 19 ... Archives: Nigerian Journal of Orthopaedics and Trauma. Journal Home > Archives: Nigerian Journal of Orthopaedics and Trauma. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current ...

  15. Editorial: Advocacy in orthopaedics | Kigera | East African ...

    African Journals Online (AJOL)

    East African Orthopaedic Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 11, No 2 (2017) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Editorial: Advocacy in orthopaedics. J.W.M. Kigera ...

  16. Surgical site infection among patients undergone orthopaedic ...

    African Journals Online (AJOL)

    Surgical site infection among patients undergone orthopaedic surgery at Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania. ... of surgical site infection at Muhimbili Orthopedic Institute was high. This was associated with more than 2 hours length of surgery, lack of prophylaxis use, and pre-operative hospital stay.

  17. East African Orthopaedic Journal: About this journal

    African Journals Online (AJOL)

    East African Orthopaedic Journal: About this journal. Journal Home > East African Orthopaedic Journal: About this journal. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. People.

  18. Orthopaedic research and education foundation and industry. (United States)

    Wurth, Gene R; Sherr, Judy H; Coffman, Thomas M


    Members of orthopaedic industry commit a significant amount of funds each year to support research and education programs that are directly related to their product(s). In addition, industry supports organizations such as the Orthopaedic Research and Education Foundation. The relationship between the Orthopaedic Research and Education Foundation and industry began in the early 1980s. The support to the Orthopaedic Research and Education Foundation from industry primarily has come in the form of unrestricted grants. These grants best can be looked at as an investment rather than a contribution. This form of giving, once called corporate philanthropy is more accurately referred to as strategic philanthropy. Members of industry make these investments to enhance their reputations, build brand awareness, market their products and services, improve employee morale, increase customer loyalty, and establish strategic alliances. The specialty of orthopaedics is among the leaders in medicine in the amount of funding raised within the specialty for research and education programs. This is because of the amount of support from members of industry and the surgeons. During the past 15 years, 40% of the annual support to the Orthopaedic Research and Education Foundation has come from industry and the balance has come from surgeons and members of lay public. Future industry support of the Orthopaedic Research and Education Foundation and other organizations within the specialty of orthopaedics will be dependent on the continued demonstration of tangible returns in areas described.

  19. Do Orthopaedic Surgeons Acknowledge Uncertainty? (United States)

    Teunis, Teun; Janssen, Stein; Guitton, Thierry G; Ring, David; Parisien, Robert


    Much of the decision-making in orthopaedics rests on uncertain evidence. Uncertainty is therefore part of our normal daily practice, and yet physician uncertainty regarding treatment could diminish patients' health. It is not known if physician uncertainty is a function of the evidence alone or if other factors are involved. With added experience, uncertainty could be expected to diminish, but perhaps more influential are things like physician confidence, belief in the veracity of what is published, and even one's religious beliefs. In addition, it is plausible that the kind of practice a physician works in can affect the experience of uncertainty. Practicing physicians may not be immediately aware of these effects on how uncertainty is experienced in their clinical decision-making. We asked: (1) Does uncertainty and overconfidence bias decrease with years of practice? (2) What sociodemographic factors are independently associated with less recognition of uncertainty, in particular belief in God or other deity or deities, and how is atheism associated with recognition of uncertainty? (3) Do confidence bias (confidence that one's skill is greater than it actually is), degree of trust in the orthopaedic evidence, and degree of statistical sophistication correlate independently with recognition of uncertainty? We created a survey to establish an overall recognition of uncertainty score (four questions), trust in the orthopaedic evidence base (four questions), confidence bias (three questions), and statistical understanding (six questions). Seven hundred six members of the Science of Variation Group, a collaboration that aims to study variation in the definition and treatment of human illness, were approached to complete our survey. This group represents mainly orthopaedic surgeons specializing in trauma or hand and wrist surgery, practicing in Europe and North America, of whom the majority is involved in teaching. Approximately half of the group has more than 10 years

  20. Eos is out of this world—literally (United States)

    Richman, Barbara T.


    When the space shuttle Endeavour launched on its 25th and final flight, AGU member and astronaut Andrew J. Feustel took with him a special bit of cargo: an issue of Eos. The accompanying photograph with the image of Eos, taken on 23 May 2011, shows the 15 February issue of Eos floating in front of one of the International Space Station windows. Below and left of the issue is the wing of Endeavour; also visible is the radiator panel on the shuttle's payload bay door. The thin blue line to the right of the issue is Earth's atmosphere. The STS-134 mission, the second to last space shuttle mission, launched on 16 May and returned to Earth on 1 June. It delivered the Alpha Magnetic Spectrometer (a particle physics experiment module) to the International Space Station along with two communications antennas, a high-pressure gas tank, and parts for the two-armed Special Purpose Dexterous Manipulator (Dextre) robot. The final shuttle mission, STS-135, launched on 8 July.

  1. Starck Ta PTW strength model recommendation for use with SESAME 93524 EoS

    Energy Technology Data Exchange (ETDEWEB)

    Sjue, Sky K. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Prime, Michael Bruce [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)


    The purpose of this document is to provide a calibration of the Preston-Tonks- Wallace (PTW) strength model for use with the new SESAME equation of state (EoS) 93524. The calibration data included in this t spans temperatures from 198 K to 673 K and strain rates from 0.001/s to 3200/s.

  2. General approach to characterizing reservoir fluids for EoS models using a large PVT database

    DEFF Research Database (Denmark)

    Varzandeh, Farhad; Stenby, Erling Halfdan; Yan, Wei


    Fluid characterization is needed when applying any EoS model to reservoir fluids. It is important especially for non-cubic models such as PC-SAFT where fluid characterization is less mature. Furthermore, there is a great interest to apply non-cubic models to high pressure high temperature reservoir...

  3. Treatment of chronic orthopaedic infection. (United States)

    Winkler, Heinz


    Chronic infections are one of the major challenges in orthopaedic surgery, both for surgeons and patients. They are characterised by obstinate persistency of the causing microorganisms and resulting long-term disablement of the patients, associated with remarkable costs for the health care system.Difficulties derive from the biofilm-mode of living of pathogens with resistances against immunological defence and antimicrobial substances, and osseous defects resulting from the disease itself and surgical interventions.Established techniques usually require multiple costly operations with extended periods of disablement and impairment of the patients, sometimes making the therapy worse than the disease.Better understanding of the backgrounds of the conditions has led to new surgical techniques and differentiated application of antibiotics, aiming in improved quality of life for our patients. Cite this article: EFORT Open Rev 2017;2. DOI: 10.1302/2058-5241.2.160063. Originally published online at

  4. ASY-EOS experiment at GSI

    Directory of Open Access Journals (Sweden)

    Kezzar K.


    Full Text Available The elliptic-flow ratio of neutrons with respect to protons in reactions of neutron rich Heavy-Ion at intermediate energies has been recently proposed as an observable sensitive to the strength of the symmetry term in the nuclear equation of state (EOS at supra-saturation densities. The recent results obtained from the existing FOPI/LAND data for 197Au+197Au collisions at 400 MeV/nucleon in comparison with the UrQMD model allowed a first estimate of the symmetry term of the EOS but suffer from a considerable statistical uncertainty. In order to obtain an improved data set for Au+Au collisions and to extend the study to other systems, a new experiment was carried out at the GSI laboratory by the ASY-EOS collaboration in May 2011.

  5. Where Are the Women in Orthopaedic Surgery? (United States)

    Rohde, Rachel S; Wolf, Jennifer Moriatis; Adams, Julie E


    Although women account for approximately half of the medical students in the United States, they represent only 13% of orthopaedic surgery residents and 4% of members of the American Academy of Orthopaedic Surgeons (AAOS). Furthermore, a smaller relative percentage of women pursue careers in orthopaedic surgery than in any other subspecialty. Formal investigations regarding the gender discrepancy in choice of orthopaedic surgery are lacking. (1) What reasons do women orthopaedic surgeons cite for why they chose this specialty? (2) What perceptions do women orthopaedic surgeons think might deter other women from pursuing this field? (3) What role does early exposure to orthopaedics and mentorship play in this choice? (4) What professional and personal choices do women in orthopaedics make, and how might this inform students who are choosing a career path? A 21-question survey was emailed to all active, candidate, and resident members of the Ruth Jackson Orthopaedic Society (RJOS, n = 556). RJOS is the oldest surgical women's organization incorporated in the United States. An independent orthopaedic specialty society, RJOS supports leadership training, mentorship, grant opportunities, and advocacy for its members and promotes sex-related musculoskeletal research. Although not all women in orthopaedic practice or training belong to RJOS, it is estimated that 42% of women AAOS fellows are RJOS members. Questions were formulated to determine demographics, practice patterns, and lifestyle choices of women who chose orthopaedic surgery as a specialty. Specifically, we evaluated the respondents' decisions about their careers and their opinions of why more women do not choose this field. For the purpose of this analysis, the influences and dissuaders were divided into three major categories: personal attributes, experience/exposure, and work/life considerations. The most common reasons cited for having chosen orthopaedic surgery were enjoyment of manual tasks (165 of 232

  6. From Physics to industry: EOS outside HEP (United States)

    Espinal, X.; Lamanna, M.


    In the competitive market for large-scale storage solutions the current main disk storage system at CERN EOS has been showing its excellence in the multi-Petabyte high-concurrency regime. It has also shown a disruptive potential in powering the service in providing sync and share capabilities and in supporting innovative analysis environments along the storage of LHC data. EOS has also generated interest as generic storage solution ranging from university systems to very large installations for non-HEP applications.

  7. International Combined Orthopaedic Research Societies: A model for international collaboration to promote orthopaedic and musculoskeletal research


    Miclau, Theodore; Adachi, Nobuo; Antoniou, John; Baldini, Nicola; Blunn, Gordon; Boyd, Steven; Chang, Je-Ken; Grimm, Bernd; Guo, X. Edward; Im, Gun-Il; Kim, Shin-Yoon; Korkusuz, Feza; Lee, Oscar Kuang-Sheng; McCaskie, Andrew; Richards, R. Geoff


    In October 2013, the International Combined Orthopaedic Research Societies (ICORS; was founded with inaugural member organisations from the previous Combined Orthopaedic Research Society, which had sponsored combined meetings for more than 2 decades. The ICORS is dedicated to the stimulation of orthopaedic and musculoskeletal research in fields such as biomedical engineering, biology, chemistry, and veterinary and human clinical research. The ICORS seeks to facilitate commu...

  8. SU-E-I-15: Comparison of Radiation Dose for Radiography and EOS in Adolescent Scoliosis Patients

    Energy Technology Data Exchange (ETDEWEB)

    Schueler, B; Walz-Flannigan, A [Mayo Clinic, Rochester, MN (United States)


    Purpose: To estimate patient radiation dose for whole spine imaging using EOS, a new biplanar slot-scanning radiographic system and compare with standard scoliosis radiography. Methods: The EOS imaging system (EOS Imaging, Paris, France) consists of two orthogonal x-ray fan beams which simultaneously acquire frontal and lateral projection images of a standing patient. The patient entrance skin air kerma was measured for each projection image using manufacturer-recommended exposure parameters for spine imaging. Organ and effective doses were estimated using a commercially-available Monte Carlo simulation program (PCXMC, STUK, Radiation and Nuclear Safety Authority, Helsinki, Finland) for a 15 year old mathematical phantom model. These results were compared to organ and effective dose estimated for scoliosis radiography using computed radiography (CR) with standard exposure parameters obtained from a survey of pediatric radiographic projections. Results: The entrance skin air kerma for EOS was found to be 0.18 mGy and 0.33 mGy for posterior-anterior (PA) and lateral projections, respectively. This compares to 0.76 mGy and 1.4 mGy for CR, PA and lateral projections. Effective dose for EOS (PA and lateral projections combined) is 0.19 mSv compared to 0.51 mSv for CR. Conclusion: The EOS slot-scanning radiographic system allows for reduced patient radiation dose in scoliosis patients as compared to standard CR radiography.

  9. Data links for the EOS TPC

    International Nuclear Information System (INIS)

    Bieser, F.; Jones, R.; McParland, C.


    We report on the design and performance of high speed data links and slower configuration control links used between the EOS TPC detector and the data processing electronics. Data rates of 5MBytes/s/link are maintained over 30m with optical isolation. Pedestal subtraction, hit detection, and data reordering are performed online. 3 refs., 1 fig

  10. Data links for the EOS TPC

    International Nuclear Information System (INIS)

    Bieser, F.; Jones, R.; McParland, C.


    This paper reports on the design and performance of high speed data links and slower configuration control links used between the EOS TPC detector and the data processing electronics. Data rates of 5 MBytes/link are maintained over 30m with optical isolation. Pedestal subtraction, hit detection, and data reordering are performed online

  11. American Orthopaedic Society for Sports Medicine (United States)

    ... Upcoming Meetings Online Education Archived Meetings Faculty Resources Sports Medicine Fellowships Traveling Fellowship Submit an Abstract Submit ... Support AOSSM Research Publications Toggle American Journal of Sports Medicine Sports Health: A Multidisciplinary Approach Orthopaedic Journal ...

  12. The financial impact of orthopaedic fellowship training. (United States)

    Gaskill, Trevor; Cook, Chad; Nunley, James; Mather, R Chad


    Previous reports have compared the expected financial return of a medical education with those expected in other professions. However, we know of no published report estimating the financial return of orthopaedic training. The purpose of this study was to estimate the financial incentives that may influence the decision to invest an additional year of training in each of the major orthopaedic fellowships. With survey data from the American Academy of Orthopaedic Surgeons and using standard financial techniques, we calculated the estimated return on investment of an additional year of orthopaedic training over a working lifetime. The net present value, internal rate of return, and the break-even point were estimated. Eight fellowships were examined and compared with general orthopaedic practice. Investment in an orthopaedic fellowship yields variable returns. Adult spine, shoulder and elbow, sports medicine, hand, and adult arthroplasty may yield positive returns. Trauma yields a neutral return, while pediatrics and foot and ankle have negative net present values. On the basis of mean reported incomes, the break-even point was two years for spine, seven years for hand, eight years for shoulder and elbow, twelve years for adult arthroplasty, thirteen years for sports medicine, and twenty-seven years for trauma. Fellowship-trained pediatric and foot and ankle surgeons did not break even following the initial investment. When working hours were controlled for, the returns for adult arthroplasty and trauma became negative. The financial return of an orthopaedic fellowship varies on the basis of the specialty chosen. While reasons to pursue fellowship training vary widely, and many are not financial, there are positive and negative financial incentives. Therefore, the decision to pursue fellowship training is best if it is not made on the basis of financial incentives. This information may assist policy makers in analyzing medical education economics to ensure the

  13. Physiotherapy following elective orthopaedic procedures. (United States)

    De Kleijn, P; Blamey, G; Zourikian, N; Dalzell, R; Lobet, S


    As haemophilic arthropathy and chronic synovitis are still the most important clinical features in people with haemophilia, different kinds of invasive and orthopaedic procedures have become more common during the last decades. The availability of clotting factor has made arthroplasty of one, or even multiple joints possible. This article highlights the role of physiotherapy before and after such procedures. Synovectomies are sometimes advocated in people with haemophilia to stop repetitive cycles of intra-articular bleeds and/or chronic synovitis. The synovectomy itself, however, does not solve the muscle atrophy, loss of range of motion (ROM), instability and poor propriocepsis, often developed during many years. The key is in taking advantage of the subsequent, relatively safe, bleed-free period to address these important issues. Although the preoperative ROM is the most important variable influencing the postoperative ROM after total knee arthroplasty, there are a few key points that should be considered to improve the outcome. Early mobilization, either manual or by means of a continuous passive mobilization machine, can be an optimal solution during the very first postoperative days. Muscle isometric contractions and light open kinetic chain exercises should also be started in order to restore the quadriceps control. Partial weight bearing can be started shortly after, because of quadriceps inhibition and to avoid excessive swelling. The use of continuous clotting factor replacement permits earlier and intensive rehabilitation during the postoperative period. During the rehabilitation of shoulder arthroplasty restoring the function of the rotator cuff is of utmost importance. Often the rotator cuff muscles are inhibited in the presence of pain and loss of ROM. Physiotherapy also assists in improving pain and maintaining ROM and strength. Functional weight-bearing tasks, such as using the upper limbs to sit and stand, are often discouraged during the first 6

  14. Audit of Orthopaedic Surgical Documentation

    Directory of Open Access Journals (Sweden)

    Fionn Coughlan


    Full Text Available Introduction. The Royal College of Surgeons in England published guidelines in 2008 outlining the information that should be documented at each surgery. St. James’s Hospital uses a standard operation sheet for all surgical procedures and these were examined to assess documentation standards. Objectives. To retrospectively audit the hand written orthopaedic operative notes according to established guidelines. Methods. A total of 63 operation notes over seven months were audited in terms of date and time of surgery, surgeon, procedure, elective or emergency indication, operative diagnosis, incision details, signature, closure details, tourniquet time, postop instructions, complications, prosthesis, and serial numbers. Results. A consultant performed 71.4% of procedures; however, 85.7% of the operative notes were written by the registrar. The date and time of surgery, name of surgeon, procedure name, and signature were documented in all cases. The operative diagnosis and postoperative instructions were frequently not documented in the designated location. Incision details were included in 81.7% and prosthesis details in only 30% while the tourniquet time was not documented in any. Conclusion. Completion and documentation of operative procedures were excellent in some areas; improvement is needed in documenting tourniquet time, prosthesis and incision details, and the location of operative diagnosis and postoperative instructions.

  15. Topology change and tensor forces for the EoS of dense baryonic matter

    International Nuclear Information System (INIS)

    Lee, Hyun Kyu; Rho, Mannque


    When skyrmions representing nucleons are put on crystal lattice and compressed to simulate high density, there is a transition above the normal nuclear matter density (n 0 ) from a matter consisting of skyrmions with integer baryon charge to a state of half-skyrmions with half-integer baryon charge. We exploit this observation in an effective field theory framework to access dense baryonic system. We find that the topology change involved in the transition implies changeover from a Fermi liquid structure to a non-Fermi liquid with the chiral condensate in the ''melted-off'' nucleon. The ∝ 80% of the nucleon mass that remains ''unmelted'', invariant under chiral transformation, points to the possible origin of the (bulk of) proton mass that is not encoded in the standard mechanism of spontaneously broken chiral symmetry. The topology change engenders a drastic modification of the nuclear tensor forces, thereby non-trivially affecting the EoS, in particular, the symmetry energy, for compact star matter. It brings in stiffening of the EoS needed to accommodate a neutron star of ∝ 2 solar mass. The strong effect on the EoS in general and in the tensor force structure in particular will also have impact on processes that could be measured at RIB-type accelerators. (orig.)

  16. Hot super-dense compact object with particular EoS (United States)

    Tito, E. P.; Pavlov, V. I.


    We show the possibility of existence of a self-gravitating spherically-symmetric equilibrium configuration for a neutral matter with neutron-like density, small mass M ≪ M_{⊙}, and small radius R ≪ R_{⊙}. We incorporate the effects of both the special and general theories of relativity. Such object may be formed in a cosmic cataclysm, perhaps an exotic one. Since the base equations of hydrostatic equilibrium are completed by the equation of state (EoS) for the matter of the object, we offer a novel, interpolating experimental data from high-energy physics, EoS which permits the existence of such compact system of finite radius. This EoS model possesses a critical state characterized by density ρc and temperature Tc. For such an object, we derive a radial distribution for the super-dense matter in "liquid" phase using Tolman-Oppenheimer-Volkoff equations for hydrostatic equilibrium. We demonstrate that a stable configuration is indeed possible (only) for temperatures smaller than the critical one. We derive the mass-radius relation (adjusted for relativistic corrections) for such small (M ≪ M_{⊙}) super-dense compact objects. The results are within the constraints established by both heavy-ion collision experiments and theoretical studies of neutron-rich matter.

  17. 3D printing: clinical applications in orthopaedics and traumatology. (United States)

    Auricchio, Ferdinando; Marconi, Stefania


    Advances in image processing have led to the clinical use of 3D printing technology, giving the surgeon a realistic physical model of the anatomy upon which he or she will operate.Relying on CT images, the surgeon creates a virtual 3D model of the target anatomy from a series of bi-dimensional images, translating the information contained in CT images into a more usable format.3D printed models can play a central role in surgical planning and in the training of novice surgeons, as well as reducing the rate of re-operation. Cite this article: Auricchio F, Marconi S. 3D printing: clinical applications in orthopaedics and traumatology. EFORT Open Rev 2016;1:121-127. DOI: 10.1302/2058-5241.1.000012.

  18. Applications of SSAFT EOS for determination of the solubilities of ...

    African Journals Online (AJOL)

    Applications of SSAFT EOS for determination of the solubilities of solid compounds in supercritical CO 2 . ... Using statistical thermodynamics such as Simplified SAFT equation of state (SSAFTEoS) for estimating phase equilibrium and fluid properties of different materials have been used widely. SSAFT EoS has been ...

  19. Strange particle measurements from the EOS TPC

    International Nuclear Information System (INIS)

    Justice, M.


    A high statistics sample of Λ's produced in 2 GeV/nucleon 5 8Ni + nat Cu collisions has been obtained with the EOS Time Projection Chamber at the Bevalac. The coverage of the EOS TPC is essentially 100% for y > y cm and extends down to P T = 0 where interesting effects such as collective radial expansion may be important. In addition, the detection of a majority of the charged particles in the TPC, along with the presence of directed flow for protons and heavier fragments at this beam energy, allows for the correlation of A production with respect to the event reaction plane. Our preliminary analysis indicates the first observation of a sidewards flow signature for A's. Comparisons with the cascade code ARC are made

  20. Bridging EO Research, Operations and Collaborative Learning (United States)

    Scarth, Peter


    Building flexible and responsive processing and delivery systems is key to getting EO information used by researchers, policy agents and the public. There are typically three distinct processes we tackle to get product uptake: undertake research, operationalise the validated research, and deliver information and garner feedback in an appropriate way. In many cases however, the gaps between these process elements are large and lead to poor outcomes. Good research may be "lost" and not adopted, there may be resistance to uptake by government or NGOs of significantly better operational products based on EO data, and lack of accessibility means that there is no use of interactive science outputs to improve cross disciplinary science or to start a dialog with citizens. So one of the the most important tasks, if we wish to have broad uptake of EO information and accelerate further research, is to link these processes together in a formal but flexible way. One of the ways to operationalize research output is by building a platform that can take research code and scale it across much larger areas. In remote sensing, this is typically a system that has access to current and historical corrected imagery with a processing pipeline built over the top. To reduce the demand on high level scientific programmers and allowing cross disciplinary researchers to hack and play and refine, this pipeline needs to be easy to use, collaborative and link to existing tools to encourage code experimentation and reuse. It is also critical to have efficient, tight integration with information delivery and extension components so that the science relevant to your user is available quickly and efficiently. The rapid expansion of open data licensing has helped this process, but building top-down web portals and tools without flexibility and regard for end user needs has limited the use of EO information in many areas. This research reports on the operalization of a scale independent time series

  1. Virtual reality (VR) techniques in orthopaedic research and practice. (United States)

    Chao, E Y; Barrance, P; Genda, E; Iwasaki, N; Kato, S; Faust, A


    Modeling the musculoskeletal joint system using biomechanical analysis and computer graphics techniques allows us to visualize normal, diseased and reconstructed joint function. This model can be used to study the loading of bones and joints under theoretical and simulated activities. In this study, intact cadavers were imaged using MRI, CT scanning and cryo-sectioning techniques. Using sequential pixel information of bone and soft tissue boundaries collected from digital camera images, MRI and CT scans, the volumetric models of the musculoskeletal joint system are reconstructed. "Descriptive geometry" techniques which treat bones as rigid bodies and cartilage, ligament and muscles as deformable bodies were used to construct the model. Joint resultant forces and moments were determined using an inverse dynamics formulation, while ligament tension, joint contact pressure, and bone stresses are solved through a simplified Rigid Body Spring Modeling technique and the Finite Element Method. The results under static and dynamic loading activities can be visualized using interactive computer graphics. The advantages of such a model are the elimination of the need for large numbers of intact cadaveric specimens, and the unprecedented capability to study joint loading responses under normal, abnormal and surgically reconstructed states. Such a model and its analytical capability are ideal for pre-operative planning and computer-assisted orthopaedic surgery. This Visual, Interactive, Computational, and Anatomic Model(VICAM) and its associated analysis capability represent the next generation of technology which will have an enormous impact in orthopaedic research, education and patient care.

  2. Radiation safety knowledge and practices among Irish orthopaedic trainees.

    LENUS (Irish Health Repository)

    Nugent, M


    Fluoroscopy is frequently used in orthopaedic surgery, particularly in a trauma setting. Exposure of patients and staff to ionising radiation has been studied extensively; however, little work has been done to evaluate current knowledge and practices among orthopaedic trainees.

  3. Inpatient consultations to an orthopaedic service: the hidden workload.

    LENUS (Irish Health Repository)

    O'Malley, N T


    While the quality and efficiency of out-patient orthopaedic referrals are well documented in the literature, there is little on the standard and appropriateness of inpatient orthopaedic consultations.

  4. Establishing a children's orthopaedic hospital for Malawi: A review ...

    African Journals Online (AJOL)

    ordinate the MNCP since 2007. At present the program has a total of 29 clinics, which have treated 5748 patients. Furthermore, BCIH has overseen the full or partial training of 5 orthopaedic surgeons and 82 orthopaedic clinical officers in Malawi.

  5. American Orthopaedic Surgeons in World War I. (United States)

    Green, David P; DeLee, Jesse C


    On April 6, 1917, the United States declared war on Germany and entered what was then called the Great War. Among the first officers sent to Europe were 21 orthopaedic surgeons in the so-called First Goldthwait Unit. Prior to the war, orthopaedics had been a nonoperative "strap-and-buckle" specialty that dealt primarily with infections, congenital abnormalities, and posttraumatic deformity. The Great War changed all of that forever, creating a new surgical specialty with emphasis on acute treatment, prevention of deformity, restoration of function, and rehabilitation.

  6. Probing a steep EoS for dark energy with latest observations (United States)

    Jaber, Mariana; Macorra, Axel de la


    We present a parametrization for the Dark Energy Equation of State "EoS" which has a rich structure, performing a transition at pivotal redshift zT between the present day value w0 to an early time wi =wa +w0 ≡ w(z ≫ 0) with a steepness given in terms of q parameter. The proposed parametrization is w =w0 +wa(z /zT) q /(1 +(z /zT)) q , with w0, wi, q and zT constant parameters. It reduces to the widely used EoS w =w0 +wa(1 - a) for zT = q = 1 . This transition is motivated by scalar field dynamics such as for example quintessence models. We study if a late time transition is favored by BAO measurements combined with local determination of H0 and information from the CMB. We find that our dynamical DE model allows to simultaneously fit H0 from local determinations and Planck CMB measurements, alleviating the tension obtained in a ΛCDM model. We obtain a smaller χ2 in our DE model than in ΛCDM showing that a dynamical DE is preferred with a reduction of 4.8%, 20.2% and 42.8% using BAO + H0, BAO + CMB and BAO + CMB + H0 datasets, respectively. However due to the increased number of free parameters in the EoS information criteria favors ΛCDM over our DE model at this stage. Nevertheless it is crucial to obtain the dynamics of DE from the observational data to show the path for theoretical DE models based on fundamental physics.

  7. Karst rocky desertification information extraction with EO-1 Hyperion data (United States)

    Yue, Yuemin; Wang, Kelin; Zhang, Bing; Jiao, Quanjun; Yu, Yizun


    Karst rocky desertification is a special kind of land desertification developed under violent human impacts on the vulnerable eco-geo-environment of karst ecosystem. The process of karst rocky desertification results in simultaneous and complex variations of many interrelated soil, rock and vegetation biogeophysical parameters, rendering it difficult to develop simple and robust remote sensing mapping and monitoring approaches. In this study, we aimed to use Earth Observing 1 (EO-1) Hyperion hyperspectral data to extract the karst rocky desertification information. A spectral unmixing model based on Monte Carlo approach, was employed to quantify the fractional cover of photosynthetic vegetation (PV), non-photosynthetic vegetation (NPV) and bare substrates. The results showed that SWIR (1.9-2.35μm) portions of the spectrum were significantly different in PV, NPV and bare rock spectral properties. It has limitations in using full optical range or only SWIR (1.9-2.35μm) region of Hyperion to decompose image into PV, NPV and bare substrates covers. However, when use the tied-SWIR, the sub-pixel fractional covers of PV, NPV and bare substrates were accurately estimated. Our study indicates that the "tied-spectrum" method effectively accentuate the spectral characteristics of materials, while the spectral unmixing model based on Monte Carlo approach is a useful tool to automatically extract mixed ground objects in karst ecosystem. Karst rocky desertification information can be accurately extracted with EO-1 Hyperion. Imaging spectroscopy can provide a powerful methodology toward understanding the extent and spatial pattern of land degradation in karst ecosystem.

  8. Patient blood management in elective orthopaedic surgery

    NARCIS (Netherlands)

    So-Osman, Cynthia


    Chapter 2 describes the results of a RCT on the effect of a restrictive trigger on RBC sparing. In three hospitals, a restrictive transfusion policy was compared with standard care transfusion policy. A randomised comparison of transfusion triggers in elective orthopaedic surgery using

  9. Getting Started in Orthopaedic Trauma Research. (United States)

    Mir, Hassan R


    Incorporating research into practice as an orthopaedic trauma surgeon can be very fulfilling. There are challenges when getting started whether in a university or other practice setting. Understanding the various components of the research process is important before beginning and thereafter. This article reviews some of the issues that may be encountered and strategies to help.

  10. Editorial: Advocacy in orthopaedics | Kigera | East African ...

    African Journals Online (AJOL)

    East African Orthopaedic Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 11, No 2 (2017) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected ...

  11. [Orthopaedic day surgery in Emilia-Romagna]. (United States)

    Rolli, M; Rodler, M; Petropulacos, K; Baldi, R


    It is well known that the organizational model of day surgery, concerning surgical problems defined by the literature as minor, has the aim of optimising the use of hospital resources and facilitating patients and their families, from a psychological and social point of view, by reducing hospitalisation time and the associated complications, and ensuring the same efficacy and more appropriateness of treatment. This study is firstly aimed at analysing the impact that the healthcare policy of the Emilia Romagna Region has had on the development of day surgery practice. Secondly, it compares the patients treated in orthopaedic day surgery in the hospitals of Bologna, Modena, Ferrara, Parma, Reggio Emilia, Maggiore hospital of Bologna and Rizzoli Orthopaedic Institute of Bologna (II.OO.R). In the period 1997-2000 there was a marked increase in the number of operations carried out in day surgery in all of the above-mentioned hospitals. Also in the unispecialistic orthopaedic hospital there was a surprising increase in the percentage of operations carried out in day surgery with respect to the total number of operations performed. The aim of the Rizzoli Orthopaedic Institute and the Emilia Romagna Region is to further implement this form of healthcare, contextually potentiating the appropriateness of hospital admission and avoiding, when not necessary, other forms of healthcare.

  12. The orthopaedic management of myelomeningocele | Horn | South ...

    African Journals Online (AJOL)

    The orthopaedic management of myelomeningocele. A Horn, S Dix-Peek, S Mears, EB Hoffman. Abstract. Despite improvement in antenatal care and screening, myelomeningocele remains the most common congenital birth defect, with a reported incidence of 1 - 2.5/1000 patients in the Western Cape, South Africa.

  13. 1 venous thromboembolism in orthopaedics references

    African Journals Online (AJOL)

    congestive cardiac failure or superficial or deep vein thrombosis. Pharmaceutical prophylaxis has been advocated and is used for high risk patients on this subject. For patients undergoing elective hip replacement consensus guidelines recommend prophylaxis upto. 35 days post surgery (3). Orthopaedic surgeons have.


    African Journals Online (AJOL)

    rationale for the application of orthopaedic subspecialization in the developing world. Data source: A pubmed search with the mesh term “subspecialization.” Data selection/extraction: Using the pubmed search engine, 452 abstracts were found discussing subspecialization. Twenty two relevant articles were found, studied ...

  15. Predonated autologous blood transfusion in elective orthopaedic ...

    African Journals Online (AJOL)

    Background: The use of homologous blood carries significant risk of viral infections and immune-mediated reactions. Preoperative autologous blood donation is an attractive alternative to homologous transfusion and has become common in elective orthopaedic surgery. Objective: To present our experience with the use of ...

  16. Future Perspective and Long-Term Strategy of the Indian EO Programme (United States)

    Rao, Mukund; Jayaraman, V.; Sridhara Murthi, K. R.; Kasturirangan, K.

    EO technology development will continue to have profound effects on spatial information activities, as we are seeing it today - the changing demand of GIS technology to understanding processes around us and its representation as maps. In the longer term, information needs will drive further RS and GIS technological developments - creating stringent demands for technology solutions for spatial data capture, integration and representation. The emergence of Spatial Business from the highly volatile and dynamic synergy of information, technology and access will see a truly Spatial Society. EO will have a major impact on day-to-day life of nations, communities and even an individual. It will become the One-stop source for information - spatial information at that - thus enabling not only development oriented activities but also Business GIS, quality research and Info-savvy communities. Internationally, there will be a mix of Government and Commercial satellites vying to provide information services to a wide variety of users. EO satellites are also becoming smaller, efficient and less costlier. Almost 5-6 commercial systems will orbit around the Earth in the foreseeable future to generate massive, seamless archives of high-resolution panchromatic and multispectral images - almost reducing the need for aerial surveys for photography and mapping. Reaching resolution of cm level and covering narrower and more spectral bands, the trend is to IMAGE the Earth in its entirety and organize Image Infrastructures. The race will be to imaginatively capture the market with the fullest archive of the globe and cater to any imaging demand of users. One will also see efficient satellite operations that will enable imaging any part of the globe with minimum turn-around time - reaching concepts of IMAGING ON DEMAND. The need of the hour is looking forward now towards how the EO technology can adapt itself to the changing scenario and the steps to be taken to sustain use of EO data it in

  17. Acute and overuse elbow trauma: radio-orthopaedics overview. (United States)

    Nocerino, Elisabetta Antonia; Cucchi, Davide; Arrigoni, Paolo; Brioschi, Marco; Fusi, Cristiano; Genovese, Eugenio A; Messina, Carmelo; Randelli, Pietro; Masciocchi, Carlo; Aliprandi, Alberto


    The correct management of acute, subacute and overuse-related elbow pathologies represents a challenging diagnostic and therapeutic problem. While major trauma frequently requires a rapid surgical intervention, subluxation and minor trauma allow taking more time for diagnostics and planning the correct elective treatment after careful clinical and radiological investigation. In these conditions, communication between orthopaedic surgeon and radiologist allow to create a detailed radiology report, tailored to the patient's and surgeon's needs and optimal to plan proper management. Imaging technique as X-Ray, CT, US, MRI, CTA and MRA all belong to the radiologist's portfolio in elbow diagnostics. Detailed knowledge of elbow pathology and its classification and of the possibilities and limits of each imaging technique is of crucial importance to reach the correct diagnosis efficiently. The aim of this review is to present the most frequent elbow pathologies and suggest a suitable diagnostic approach for each of them.

  18. MRI for the evaluation of knee pain: comparison of ordering practices of primary care physicians and orthopaedic surgeons. (United States)

    Roberts, Timothy T; Singer, Natalie; Hushmendy, Shazaan; Dempsey, Ian J; Roberts, Jared T; Uhl, Richard L; Johnson, Paul E M


    Knee pain is one of the most common reasons for outpatient visits in the U.S. The great majority of such cases can be effectively evaluated through physical examination and judicious use of radiography. Despite this, an increasing number of magnetic resonance images (MRIs) of the knee are being ordered for patients with incomplete work-ups or for inappropriate indications. We hypothesized that MRIs ordered by orthopaedic providers were more likely to result in changes in diagnoses and/or plans for care than those ordered by non-orthopaedic providers. We reviewed the charts of all consecutive new patients seen at our orthopaedic outpatient office between January 1, 2010, and December 31, 2011, with International Classification of Diseases, Ninth Revision (ICD-9) codes for meniscal or unspecific sprains and strains of the knee. A total of 1592 patients met our inclusion criteria and were divided into two groups: those initially evaluated and referred by their primary care physician (PCP) (n = 747) and those initially evaluated by one of our staff orthopaedic surgeons (n = 845). MRI-ordering rates were nearly identical between orthopaedic surgeons and PCPs (25.0% versus 24.8%; p = 0.945). MRIs ordered by orthopaedic surgeons, however, resulted in significantly more arthroscopic interventions than those ordered by PCPs (41.2% versus 31.4%; p = 0.042). Orthopaedic surgeons ordered MRIs for patients who were more likely to benefit from arthroscopic intervention, including patients who were younger (mean age, 45.1 years versus 56.5 years for those with PCP-ordered MRIs; p knee arthroplasty (4.3% versus 9.2%; p = 0.048). MRI utilization by orthopaedic surgeons results in more appropriate interventions for patients with symptoms and findings most amenable to surgical intervention. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

  19. Eye safe lidar and passive EO sensing for cloud monitoring (United States)

    Steinvall, Ove; Gustafsson, Ove; Berglund, Folke


    This study has investigated the use of an eye safe lidar (1550 nm) with equivalent performance of an ordinary military laser range finder for cloud monitoring. The aim was to combine lidar data with camera images in the visible, short wave infrared (SWIR) and infrared (IR) to better estimate the cloud density and cloud coverage. The measurement was concentrated on low clouds, mostly of the cumulus type. We found that these clouds between 0-2 km often showed a layered structure and that they often indicated a limited optical density probably allowing for observation through the cloud. This information is hard to achieve from a passive EO sensor only. This was supported both from the simulation of the lidar response from thin clouds and from inverting the measured lidar waveform. The comparison between the camera image intensities and the integrated range corrected lidar signals showed both negative and positive correlations. The highest positive correlation was obtained from comparing the lidar signal with the cloud temperature as derived from the FLIR camera. However, there were many cases when one or two of the camera intensities correlated negatively with the lidar signal. We could for example observe that under certain conditions the cloud which was dark in the SWIR appeared as white in the visible camera and vice versa. Example of lidar and image data will be presented and analyzed.

  20. The Placenta: Applications in Orthopaedic Sports Medicine. (United States)

    McIntyre, James Alexander; Jones, Ian A; Danilkovich, Alla; Vangsness, C Thomas


    Placenta has a long history of use for treating burns and wounds. It is a rich source of collagen and other extracellular matrix proteins, tissue reparative growth factors, and stem cells, including mesenchymal stem cells (MSCs). Recent data show its therapeutic potential for orthopaedic sports medicine indications. To provide orthopaedic surgeons with an anatomic description of the placenta, to characterize its cellular composition, and to review the literature reporting the use of placenta-derived cells and placental tissue allografts for orthopaedic sports medicine indications in animal models and in humans. Systematic review. Using a total of 63 keyword combinations, the PubMed and MEDLINE databases were searched for published articles describing the use of placental cells and/or tissue for orthopaedic sports medicine indications. Information was collected on placental tissue type, indications, animal model, study design, treatment regimen, safety, and efficacy outcomes. Results were categorized by indication and subcategorized by animal model. Outcomes for 29 animal studies and 6 human studies reporting the use of placenta-derived therapeutics were generally positive; however, the placental tissue source, clinical indication, and administration route were highly variable across these studies. Fourteen animal studies described the use of placental tissue for tendon injuries, 13 studies for osteoarthritis or articular cartilage injuries, 3 for ligament injuries, and 1 for synovitis. Both placenta-derived culture-expanded cells (epithelial cells or MSCs) and placental tissue allografts were used in animal studies. In all human studies, commercial placental allografts were used. Five of 6 human studies examined the treatment of foot and ankle pathological conditions, and 1 studied the treatment of knee osteoarthritis. A review of the small number of reported studies revealed a high degree of variability in placental cell types, placental tissue preparation, routes

  1. Critical roles of orthopaedic surgeon leadership in healthcare systems to improve orthopaedic surgical patient safety. (United States)

    Kuo, Calvin C; Robb, William J


    The prevention of medical and surgical harm remains an important public health problem despite increased awareness and implementation of safety programs. Successful introduction and maintenance of surgical safety programs require both surgeon leadership and collaborative surgeon-hospital alignment. Documentation of success of such surgical safety programs in orthopaedic practice is limited. We describe the scope of orthopaedic surgical patient safety issues, define critical elements of orthopaedic surgical safety, and outline leadership roles for orthopaedic surgeons needed to establish and sustain a culture of safety in contemporary healthcare systems. We identified the most common causes of preventable surgical harm based on adverse and sentinel surgical events reported to The Joint Commission. A comprehensive literature review through a MEDLINE(®) database search (January 1982 through April 2012) to identify pertinent orthopaedic surgical safety articles found 14 articles. Where gaps in orthopaedic literature were identified, the review was supplemented by 22 nonorthopaedic surgical references. Our final review included 36 articles. Six important surgical safety program elements needed to eliminate preventable surgical harm were identified: (1) effective surgical team communication, (2) proper informed consent, (3) implementation and regular use of surgical checklists, (4) proper surgical site/procedure identification, (5) reduction of surgical team distractions, and (6) routine surgical data collection and analysis to improve the safety and quality of surgical patient care. Successful surgical safety programs require a culture of safety supported by all six key surgical safety program elements, active surgeon champions, and collaborative hospital and/or administrative support designed to enhance surgical safety and improve surgical patient outcomes. Further research measuring improvements from such surgical safety systems in orthopaedic care is needed.

  2. Holographic bulk viscosity: GPR vs EO

    CERN Document Server

    Buchel, Alex; Kiritsis, Elias


    Recently Eling and Oz (EO) proposed a formula for the holographic bulk viscosity, in arXiv:1103.1657, derived from the null horizon focusing equation. This formula seems different from that obtained earlier by Gubser, Pufu and Rocha (GPR) in arXiv:0806.0407 calculated from the IR limit of the two-point function of the trace of the stress tensor. The two were shown to agree only for some simple scaling cases. We point out that the two formulae agree in two non-trivial holographic theories describing RG flows. The first is the strongly coupled N=2* gauge theory plasma. The second is the semi-phenomenological model of Improved Holographic QCD.

  3. The ASY-EOS Experiment at GSI

    Directory of Open Access Journals (Sweden)

    Russotto P.


    Full Text Available The elliptic-flow ratio of neutrons with respect to protons or light complex particles in reactions of heavy ions at pre-relativistic energies has been proposed as an observable sensitive to the strength of the symmetry term of the nuclear equation of state at supra-saturation densities. In the ASY-EOS experiment at the GSI laboratory, flows of neutrons and light charged particles were measured for 197Au+197Au collisions at 400 MeV/nucleon. Flow results obtained for the Au+Au system, in comparison with predictions of the UrQMD transport model, confirm the moderately soft to linear density dependence of the symmetry energy deduced from the earlier FOPI-LAND data.

  4. What We Have Learned with 16 Years of EO-1 Hyperion (United States)

    Ungar, S.


    The Earth Observing-One (EO-1) satellite, launched in November of 2000, will complete its sixteenth and final year of operation at the end of calendar year 2016. Observations from the Hyperion Imaging Spectrometer on board EO-1 have contributed to hundreds of papers in refereed journals, conference proceeds and other presentations. The EO-1 Hyperion imaging spectrometer is the first and longest operating instrument that provides visible to shortwave infrared science-grade data from orbit. Hyperion has been used to study a variety of natural and anthropogenic phenomena including hazards and catastrophes, agricultural health and productivity, ecological disturbance/development, and land use/land cover change. As an example, Hyperion has been used in hazard and catastrophe studies to monitor and assess effects of tsunamis, earthquakes, volcanic eruptions, mudslides, tornadoes, hurricanes, wild-fires (natural and human ignited), oil spills, and the aftermath of world trade center bombing. This presentation summarizes the current status of EO-1 Hyperion in terms of key scientific findings to date and presents future plans for exploiting the upward of 90,000 scenes expected to be archived at USGS EROS by the end of the mission. Hyperion serves as the heritage orbital spectrometer for future global platforms, including the proposed NASA Hyperspectral Infrared Imager (HyspIRI) and the forthcoming German satellite, EnMAP. A key EO-1 mission goal was to evaluate the ability of satellite high spectral resolution imaging to characterize terrestrial surface state and processes at 30 m resolution. Researchers engaged in NASA's Terrestrial Ecology, Carbon Science, Land Use Change and other programs using the EO-1 Hyperion imaging spectrometer have achieved results with accuracies far exceeding those reached with the current spaceborne fleet of multispectral sensors. Hyperion data provide several advantages over data from multispectral satellite systems: they inherently provide

  5. Journal of Orthopaedic Surgery and Research Editorial

    Directory of Open Access Journals (Sweden)

    Chan Kai-Ming


    Full Text Available Abstract Journal of Orthopaedic Surgery and Research is an open access, online journal that aims to expeditiously publish clinical and basic research studies related to musculoskeletal issues in different cultural communities. It provides a platform for exchanges of new clinical and scientific information in the most precise and expeditious way to achieve dissemination of information and cross-fertilization of ideas. The open access nature of this journal allows articles to be universally and freely accessible via the Internet. This ensures a rapid and efficient communication of research findings. The journal welcomes all types of articles related to musculoskeletal issues. Its timely publication and high visibility are the two most important features that make this journal different from other traditional journals in the orthopaedic field.

  6. Terrestrial remote sensing science and algorithms planned for EOS/MODIS (United States)

    Running, S. W.; Justice, C.O.; Salomonson, V.V.; Hall, D.; Barker, J.; Kaufmann, Y. J.; Strahler, Alan H.; Huete, A.R.; Muller, Jan-Peter; Vanderbilt, V.; Wan, Z.; Teillet, P.; Carneggie, David M. Geological Survey (U.S.) Ohlen


    The Moderate Resolution Imaging Spectroradiometer (MODIS) will be the primary daily global monitoring sensor on the NASA Earth Observing System (EOS) satellites, scheduled for launch on the EOS-AM platform in June 1998 and the EOS-PM platform in December 2000. MODIS is a 36 channel radiometer covering 0·415-14·235 μm wavelengths, with spatial resolution from 250 m to 1 km at nadir. MODIS will be the primary EOS sensor for providing data on terrestrial biospheric dynamics and process activity. This paper presents the suite of global land products currently planned for EOSDIS implementation, to be developed by the authors of this paper, the MODIS land team (MODLAND). These include spectral albedo, land cover, spectral vegetation indices, snow and ice cover, surface temperature and fire, and a number of biophysical variables that will allow computation of global carbon cycles, hydrologic balances and biogeochemistry of critical greenhouse gases. Additionally, the regular global coverage of these variables will allow accurate surface change detection, a fundamental determinant of global change.

  7. Maximizing the use of EO products: how to leverage the potential of open geospatial service architectures (United States)

    Usländer, Thomas


    The demand for the rapid provision of EO products with well-defined characteristics in terms of temporal, spatial, image-specific and thematic criteria is increasing. Examples are products to support near real-time damage assessment after a natural disaster event, e.g. an earthquake. However, beyond the organizational and economic questions, there are technological and systemic barriers to enable a comfortable search, order, delivery or even combination of EO products. Most portals of space agencies and EO product providers require sophisticated satellite and product knowledge and, even worse, are all different and not interoperable. This paper gives an overview about the use cases and the architectural solutions that aim at an open and flexible EO mission infrastructure with application-oriented user interfaces and well-defined service interfaces based upon open standards. It presents corresponding international initiatives such as INSPIRE (Infrastructure for Spatial Information in the European Community), GMES (Global Monitoring for Environment and Security), GEOSS (Global Earth Observation System of Systems) and HMA (Heterogeneous Missions Accessibility) and their associated infrastructure approaches. The paper presents a corresponding analysis and design methodology and two examples how such architectures are already successfully used in early warning systems for geo-hazards and toolsets for environmentallyinduced health risks. Finally, the paper concludes with an outlook how these ideas relate to the vision of the Future Internet.

  8. Leadership and business education in orthopaedic residency training programs. (United States)

    Kiesau, Carter D; Heim, Kathryn A; Parekh, Selene G


    Leadership and business challenges have become increasingly present in the practice of medicine. Orthopaedic residency programs are at the forefront of educating and preparing orthopaedic surgeons. This study attempts to quantify the number of orthopaedic residency programs in the United States that include leadership or business topics in resident education program and to determine which topics are being taught and rate the importance of various leadership characteristics and business topics. A survey was sent to all orthopaedic department chairpersons and residency program directors in the United States via e-mail. The survey responses were collected using a survey collection website. The respondents rated the importance of leadership training for residents as somewhat important. The quality of character, integrity, and honesty received the highest average rating among 19 different qualities of good leaders in orthopaedics. The inclusion of business training in resident education was also rated as somewhat important. The topic of billing and coding received the highest average rating among 14 different orthopaedically relevant business topics. A variety of topics beyond the scope of clinical practice must be included in orthopaedic residency educational curricula. The decreased participation of newly trained orthopaedic surgeons in leadership positions and national and state orthopaedic organizations is concerning for the future of orthopaedic surgery. Increased inclusion of leadership and business training in resident education is important to better prepare trainees for the future.

  9. The 2016 American Orthopaedic Association-Japanese Orthopaedic Association Traveling Fellowship. (United States)

    Nandi, Sumon; Cho, Samuel K; Freedman, Brett A; Firoozabadi, Reza


    The American Orthopaedic Association-Japanese Orthopaedic Association (AOA-JOA) Traveling Fellowship, which began in 1992 as a collaborative effort between the 2 orthopaedic communities, is aimed at fostering leadership among early-career surgeons through clinical, academic, and cultural exchange. Over 3 weeks, we experienced an extraordinary journey that led us across nearly 800 miles of the picturesque Japanese countryside, with stops at 6 distinguished academic centers. The opportunity to become personally acquainted with orthopaedic leaders in Japan, learn from their experiences, and immerse ourselves in the ancient and storied culture of a beautiful country was one that we will not soon forget. Along the way, we accumulated a wealth of information while enjoying the legendary hospitality of the Japanese people. There is a ubiquitous challenge in delivering cost-effective, accessible health care while maintaining a commitment to education and research. The U.S. orthopaedic community may take solace in the fact that our Japanese colleagues stand with us as partners in this pursuit, and our relationship with them continues to grow stronger through endeavors such as the AOA-JOA Traveling Fellowship. We look forward to honoring our Japanese colleagues in 2017 when we host them in the United States.

  10. Improving parental satisfaction in pediatric orthopaedics. (United States)

    Williams, Geraint; Pattison, Giles; Mariathas, Chrishan; Lazar, Joanna; Rashied, Muhammad


    No previous studies have attempted to measure parental satisfaction and service quality with regards to pediatric orthopaedic inpatient care. We performed a prospective observational study to identify areas of inpatient care which might be improved to increase overall parental satisfaction. We used the validated Swedish parent satisfaction questionnaire to generate data from 104 pediatric orthopaedic hospital inpatients between August 2009 and May 2010 (49 elective and 55 trauma pediatric orthopaedic admissions; median age range, 2 to 6 y). Questions focused on 8 domains of quality: information on illness, information on routines, accessibility, medical treatment, care processes, staff attitudes, parent participation, and staff work environment. Scores generated a percentage of the maximum achievable for that quality index. Data were analyzed using recognized statistical methods. Overall mean combined scores for the care indices were highest for parents' perception of "medical treatment" (95%) and "staff attitudes" (95%). The medical treatment index includes questions regarding staff member's skill and competence. Lowest scores corresponded to the index "information on routines" (86%). Information on routines applies to parental awareness of ward rounds, to whom questions should be directed and which doctors and nursing staff are responsible for their child's care. Lower scores in relation to this index were substantiated by comments from relatives requesting greater information provision. The information parents required was routinely provided suggesting that retention rather than lack of information is the main issue. Provision of information pamphlets tailored to common injuries or elective procedures might prove an effective method for improving parental satisfaction and overall care. Improving information provision and parental retention of this information is the strategy most likely to improve quality of service and parental satisfaction for pediatric

  11. Associations of diabetes mellitus with orthopaedic infections. (United States)

    Al-Mayahi, Mohamed; Cian, Anais; Kressmann, Benjamin; de Kalbermatten, Benedicte; Rohner, Peter; Egloff, Michael; Jafaar, Jafaar; Malacarne, Sarah; Miozzari, Hermes H; Uçkay, Ilker


    Clinical experience suggests that a high proportion of orthopaedic infections occur in persons with diabetes. We reviewed several databases of adult patients hospitalized for orthopaedic infections at Geneva University Hospitals from 2004 to 2014 and retrieved 2740 episodes of infection. Overall, diabetes was noted in the medical record for 659 (24%) of these cases. The patients with, compared with those without, diabetes had more than five times more foot infections (274/659 [42%] vs 155/2081 [7%]; p < 0.01) and a significantly higher serum C-reactive protein level at admission (median 96 vs 70 mg/L; p < 0.01). Diabetic patients were older (median 67 vs 52 years; p < 0.01), more often male (471 [71%] vs 1398 [67%]; p = 0.04), and had more frequent polymicrobial infections (219 [37%] vs 353 [19%]; p < 0.01), including more gram-negative non-fermenting rods (90 [15%] vs 168 [9%]; p < 0.01). Excluding foot infections from these analyses did not change the statistically significant differences. Diabetes was present in 17% of all infected orthopaedic patients without foot involvement. In Geneva canton, the overall prevalence of diabetes is estimated at 5.1%, while we have found that the prevalence is 13% in our hospitalized adults. Diabetes is present in 24% of all adult patients hospitalized for surgery for an orthopaedic infection, a prevalence that is several times higher than for the general population and twice as high as that for the population of hospitalized patients. Compared with non-diabetics, patients with diabetes have significantly more infections that are polymicrobial, including gram-negative non-fermenting rods.

  12. Clinical trial networks in orthopaedic surgery. (United States)

    Rangan, A; Jefferson, L; Baker, P; Cook, L


    The aim of this study was to review the role of clinical trial networks in orthopaedic surgery. A total of two electronic databases (MEDLINE and EMBASE) were searched from inception to September 2013 with no language restrictions. Articles related to randomised controlled trials (RCTs), research networks and orthopaedic research, were identified and reviewed. The usefulness of trainee-led research collaborations is reported and our knowledge of current clinical trial infrastructure further supplements the review. Searching yielded 818 titles and abstracts, of which 12 were suitable for this review. Results are summarised and presented narratively under the following headings: 1) identifying clinically relevant research questions; 2) education and training; 3) conduct of multicentre RCTs and 4) dissemination and adoption of trial results. This review confirms growing international awareness of the important role research networks play in supporting trials in orthopaedic surgery. Multidisciplinary collaboration and adequate investment in trial infrastructure are crucial for successful delivery of RCTs. Cite this article: Bone Joint Res 2014;3:169-74. ©2014 The British Editorial Society of Bone & Joint Surgery.

  13. Vitamin D deficiency: a paediatric orthopaedic perspective. (United States)

    Clarke, Nicholas M P; Page, Jonathan E


    At the turn of the last century, rickets (vitamin D deficiency) was one of the most common musculoskeletal diseases of the paediatric population presenting to physicians. Today, the most common referral pathway for these patients ends in a paediatric orthopaedic outpatient clinic. Vitamin D deficiency is a clinical entity that can affect all children and should be looked for in all children with musculoskeletal symptoms. The child at risk of rickets is now white, breastfed, protected from the sun and obese. Vitamin D deficiency can present as atypical muscular pain, pathological fractures or slipped upper femoral epiphysis. Obesity is linked with lower vitamin D levels; however, in the paediatric population, this does not necessarily equal clinical disorder. Vitamin D supplements can be used to reduce the risk of pathological fractures in the cerebral palsy child. It should also form part of the differential diagnosis in the work-up of nonaccidental injuries. Children with a low vitamin D present with a higher incidence of fractures from normal activities. Vitamin D levels need to be assessed before any form of orthopaedic surgery, as it can affect growth, both in the diaphysis of the bone and in the growth plate. Vitamin D levels are a key element in the successful practice of paediatric orthopaedics. It is not just the possible cause of disorder presenting to the clinician but also extremely important in ensuring the successful postoperative recovery of the patient.

  14. Orthopaedic Rehabilitation Device Actuated with Pneumatic Muscles

    Directory of Open Access Journals (Sweden)

    Ioana Petre


    Full Text Available Year after year recovery clinics worldwide report significant numbers of lower limb bearing joint disabilities. An effective method for the speedy rehabilitation of patients with such afflictions is Continuous Passive Motion (CPM, drawing upon a range of specific equipment. This paper presents an innovative constructive solution for such orthopaedic rehabilitation equipment, designed to ensure a swift reintegration of patients at as low a cost as possible. The absolute novelty consists in the utilization of the linear pneumatic muscle as actuator of the orthopaedic rehabilitation equipment, thus achieving a light and highly compliant construction that satisfies safety requirements related to man-machine interaction. Pneumatic muscles are bio-inspired actuation systems characterized by a passive variable compliant behaviour. This property, deployed in rehabilitation systems, enables the development of human friendly devices, which are comfortable for the patients, and capable of safe interaction. This paper presents the constructive schematic of the orthopaedic rehabilitation equipment, the structure of the actuation and positioning system, and several of its functional characteristics.

  15. Organ dose and effective dose with the EOS scanner in spine deformity surgery

    DEFF Research Database (Denmark)

    Heide Pedersen, Peter; Petersen, Asger Greval; Eiskjær, Søren Peter


    Organ dose and effective dose with the EOS scanner in spine deformity surgery. A study on anthropomorphic phantoms describing patient radiation exposure in full spine examinations. Authors: Peter Heide Pedersen, Asger Greval Petersen, Søren Peter Eiskjær. Background: Ionizing radiation potentially...... quality images while at the same time reducing radiation dose. At our institution we use the EOS for pre- and postoperative full spine examinations. Purpose: The purpose of the study is to make first time organ dose and effective dose evaluations with micro-dose settings in full spine examinations. Our...... hypothesis is that organ dose and effective doses can be reduced 5-10 times compared to standard settings, without too high image-quality trade off, resulting in a theoretical reduction of radiation induced cancer. Methods: Patient dosimetry is performed on anthropomorphic child phantoms, representing a 5...

  16. Eos a Universal Verifiable and Coercion Resistant Voting Protocol

    DEFF Research Database (Denmark)

    Patachi, Stefan; Schürmann, Carsten


    Authority. Eos uses two mixing phases with the goal to break the connection between the voter and vote, not to preserve vote privacy (which is given already) but to guarantee coercion resistance by making it (nearly) impossible for a coercer to follow their vote through the bulletin board. Eos...

  17. Integrating new Storage Technologies into EOS (United States)

    Peters, Andreas J.; van der Ster, Dan C.; Rocha, Joaquim; Lensing, Paul


    The EOS[1] storage software was designed to cover CERN disk-only storage use cases in the medium-term trading scalability against latency. To cover and prepare for long-term requirements the CERN IT data and storage services group (DSS) is actively conducting R&D and open source contributions to experiment with a next generation storage software based on CEPH[3] and ethernet enabled disk drives. CEPH provides a scale-out object storage system RADOS and additionally various optional high-level services like S3 gateway, RADOS block devices and a POSIX compliant file system CephFS. The acquisition of CEPH by Redhat underlines the promising role of CEPH as the open source storage platform of the future. CERN IT is running a CEPH service in the context of OpenStack on a moderate scale of 1 PB replicated storage. Building a 100+PB storage system based on CEPH will require software and hardware tuning. It is of capital importance to demonstrate the feasibility and possibly iron out bottlenecks and blocking issues beforehand. The main idea behind this R&D is to leverage and contribute to existing building blocks in the CEPH storage stack and implement a few CERN specific requirements in a thin, customisable storage layer. A second research topic is the integration of ethernet enabled disks. This paper introduces various ongoing open source developments, their status and applicability.

  18. Integrating new Storage Technologies into EOS

    CERN Document Server

    Peters, Andreas J; Rocha, Joaquim; Lensing, Paul


    The EOS[1] storage software was designed to cover CERN disk-only storage use cases in the medium-term trading scalability against latency. To cover and prepare for long-term requirements the CERN IT data and storage services group (DSS) is actively conducting R&D; and open source contributions to experiment with a next generation storage software based on CEPH[3] and ethernet enabled disk drives. CEPH provides a scale-out object storage system RADOS and additionally various optional high-level services like S3 gateway, RADOS block devices and a POSIX compliant file system CephFS. The acquisition of CEPH by Redhat underlines the promising role of CEPH as the open source storage platform of the future. CERN IT is running a CEPH service in the context of OpenStack on a moderate scale of 1 PB replicated storage. Building a 100+PB storage system based on CEPH will require software and hardware tuning. It is of capital importance to demonstrate the feasibility and possibly iron out bottlenecks and blocking issu...

  19. Image catalogs. (United States)

    Gomoll, Andreas H; Thornhill, Thomas S


    The advent of digital photography and radiography allows documentation of interesting clinical findings with unprecedented ease, and many orthopaedic surgeons have taken extensive advantage of this opportunity to create large digital libraries of clinical results. However, this leaves surgeons with a rapidly increasing volume of data to store and organize; therefore, a system for archiving, locating, and managing images, radiographs, and digital slide presentations has become a crucial need in most orthopaedic groups and practices. However, many surgical groups and practices are not familiar with the computer technology available to initiate such systems. In this review, we discuss several software solutions currently on the market to address the specific needs of orthopaedic surgeons, and as a practical example, discuss a system that is in place in the Department of Orthopaedic Surgery at our institution. Overall, depending on the individual circumstances of each institution, there are various options that meet different technologic and financial requirements.

  20. Aspirin for Prophylaxis Against Venous Thromboembolism After Orthopaedic Oncologic Surgery. (United States)

    Mendez, Gregory M; Patel, Yash M; Ricketti, Daniel A; Gaughan, John P; Lackman, Richard D; Kim, Tae Won B


    Patients who undergo orthopaedic oncologic surgical procedures are at increased risk of developing a venous thromboembolism (VTE). Guidelines from surgical societies are shifting to include aspirin as a postoperative VTE prophylactic agent. The purpose of this study was to review our experience using aspirin as postoperative VTE prophylaxis for orthopaedic oncologic surgical procedures. This study was a retrospective review of patients diagnosed with a primary malignant soft-tissue or bone tumor or metastatic carcinoma. Demographic information, histopathologic diagnosis, VTE history, surgical procedure, and VTE prophylaxis were analyzed. VTE rates in the overall and prophylactic-specific cohorts were recorded and compared. A total of 142 distinct surgical procedures in 130 patients were included. VTE prophylaxis with aspirin was used after 103 procedures, and non-aspirin prophylaxis was used after 39. In 33 cases, imaging was used to investigate for VTE because of clinical signs and symptoms. VTE developed after 7 (4.9%) of the 142 procedures. There were 6 deep venous thromboses (DVTs) and 1 pulmonary embolism, and 2 of the VTEs presented in patients with a VTE history. VTE developed in 2.9% (3) of the 103 aspirin cases and 10.3% (4) of the 39 non-aspirin cases. No patient in the aspirin group who had been diagnosed with metastatic carcinoma, malignant soft-tissue sarcoma, lymphoma, or multiple myeloma developed a VTE. Risk factors for VTE development included diabetes mellitus (odds ratio [OR] = 10.40, 95% confidence interval [CI] = 1.61 to 67.30), a history of VTE (OR = 7.26, 95% CI = 1.19 to 44.25), postoperative transfusion (OR = 34.50, 95% CI = 3.94 to 302.01), and estimated blood losses of 250 mL (OR = 1.50, 95% CI = 1.11 to 2.03), 500 mL (OR = 2.26, 95% CI = 1.23 to 4.13), and 1,000 mL (OR = 5.10, 95% CI = 1.52 to 17.04). Aspirin may be a suitable and effective option for VTE chemoprophylaxis in patients treated with orthopaedic oncologic surgery, especially

  1. Is There Value in Having Radiology Provide a Second Reading in Pediatric Orthopaedic Clinic? (United States)

    Natarajan, Vivek; Bosch, Patrick; Dede, Ozgur; Deeney, Vincent; Mendelson, Stephen; Ward, Timothy; Brooks, Maria; Kenkre, Tanya; Roach, James


    The Joint Commission on Accreditation of Healthcare Organizations specifically mandates the dual interpretation of musculoskeletal radiographs by a radiologist in addition to the orthopaedist in all hospital-based orthopaedic clinics. Previous studies have questioned the utility of this practice. The purpose of this study was to further investigate the clinical significance of having the radiologist provide a second interpretation in a hospital-based pediatric orthopaedic clinic. A retrospective review was performed of all patients who had plain radiographs obtained in the pediatric orthopaedic clinic at an academic children's hospital over a 4-month period. For each radiographic series, the orthopaedist's note and the radiology interpretation were reviewed and a determination was made of whether the radiology read provided new clinically useful information and/or a new diagnosis, whether it recommended further imaging, or if it missed a diagnosis that was reflected in the orthopaedist's note. The hospital charges associated with the radiology read for each study were also quantified. The charts of 1570 consecutive clinic patients who were seen in the pediatric orthopaedic clinic from January to April, 2012 were reviewed. There were 2509 radiographic studies performed, of which 2264 had both a documented orthopaedist's note and radiologist's read. The radiologist's interpretation added new, clinically important information in 1.0% (23/2264) of these studies. In 1.7% (38/2264) of the studies, it was determined that the radiologist missed the diagnosis or clinically important information that could affect treatment. The total amount of the professional fees charged for the radiologists' interpretations was $87,362. On average, the hospital charges for each occurrence in which the radiologist's read provided an additional diagnosis or clinically important information beyond the orthopaedist's note were $3798. The results of this study suggest that eliminating the

  2. The burden of gunshot injuries on orthopaedic healthcare resources in South Africa

    Directory of Open Access Journals (Sweden)

    Case Martin


    Full Text Available Background. Injuries inflicted by gunshot wounds (GSWs are an immense burden on the South African (SA healthcare system. In 2005, Allard and Burch estimated SA state hospitals treated approximately 127 000 firearm victims annually and concluded that the cost of treating an abdominal GSW was approximately USD1 467 per patient. While the annual number of GSW injuries has decreased over the past decade, an estimated 54 870 firearm-related injuries occurred in SA in 2012. No study has estimated the burden of these GSWs from an orthopaedic perspective. Objective. To estimate the burden and average cost of treating GSW victims requiring orthopaedic interventions in an SA tertiary level hospital. Methods. This retrospective study surveyed more than 1 500 orthopaedic admissions over a 12-month period (2012 at Groote Schuur Hospital, Cape Town, SA. Chart review subsequently yielded data that allowed analysis of cost, theatre time, number and type of implants, duration of admission, diagnostic imaging studies performed, blood products used, laboratory studies ordered and medications administered. Results. A total of 111 patients with an average age of 28 years (range 13 - 74 were identified. Each patient was hit by an average of 1.69 bullets (range 1 - 7. These patients sustained a total of 147 fractures, the majority in the lower extremities. Ninety-five patients received surgical treatment for a total of 135 procedures, with a cumulative surgical theatre time of >306 hours. Theatre costs, excluding implants, were in excess of USD94 490. Eighty of the patients received a total of 99 implants during surgery, which raised theatre costs an additional USD53 381 cumulatively, or USD667 per patient. Patients remained hospitalised for an average of 9.75 days, and total ward costs exceeded USD130 400. Individual patient costs averaged about USD2 940 (ZAR24 945 per patient. Conclusion. This study assessed the burden of orthopaedic firearm injuries in SA. It was

  3. What is orthopaedic triage? A systematic review. (United States)

    Morris, Joanne H; James, Rebecca E; Davey, Rachel; Waddington, Gordon


    Complex and chronic disease is placing significant pressure on hospital outpatient departments. Novel ways of delivering care have been developed recently and are often described as 'triage' services. This paper reviews the literature pertaining to definitions and descriptions of orthopaedic/musculoskeletal triage processes, in order to provide information on 'best practice' to assist health care facilities. A comprehensive open-ended search was conducted using electronic databases to identify studies describing models of triage clinics for patients with a musculoskeletal/orthopaedic complaint, who have been referred to hospital outpatient clinics for a surgical consultation. Studies were critically appraised using the McMaster quality appraisal tool and ranked using the National Health and Medical Research Council hierarchy of evidence. A thematic analysis of the definitions, processes and procedures of triage described within the literature was undertaken. 1930 studies were identified and 45 were included in the review (including diagnostic and evaluative research). The hierarchy of evidence ranged from I to IV; however, the majority were at low levels of evidence and scored poorly on the critical appraisal tool. Three broad themes of triage were identified: presence of a referral, configuration of the triage (who, how and where) and the aim of triage. However, there were significant inconsistencies across these themes. This systematic review highlighted the need for standardization of the definition of triage, the procedures of assessment and management and measures of outcome used in orthopaedic/musculoskeletal triage to ensure best-practice processes, procedures and outcomes for triage clinics. © 2014 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

  4. What is orthopaedic triage? A systematic review (United States)

    Morris, Joanne H; James, Rebecca E; Davey, Rachel; Waddington, Gordon


    Rationale, aims and objectives Complex and chronic disease is placing significant pressure on hospital outpatient departments. Novel ways of delivering care have been developed recently and are often described as ‘triage’ services. This paper reviews the literature pertaining to definitions and descriptions of orthopaedic/musculoskeletal triage processes, in order to provide information on ‘best practice’ to assist health care facilities. Method A comprehensive open-ended search was conducted using electronic databases to identify studies describing models of triage clinics for patients with a musculoskeletal/orthopaedic complaint, who have been referred to hospital outpatient clinics for a surgical consultation. Studies were critically appraised using the McMaster quality appraisal tool and ranked using the National Health and Medical Research Council hierarchy of evidence. A thematic analysis of the definitions, processes and procedures of triage described within the literature was undertaken. Results 1930 studies were identified and 45 were included in the review (including diagnostic and evaluative research). The hierarchy of evidence ranged from I to IV; however, the majority were at low levels of evidence and scored poorly on the critical appraisal tool. Three broad themes of triage were identified: presence of a referral, configuration of the triage (who, how and where) and the aim of triage. However, there were significant inconsistencies across these themes. Conclusions This systematic review highlighted the need for standardization of the definition of triage, the procedures of assessment and management and measures of outcome used in orthopaedic/musculoskeletal triage to ensure best-practice processes, procedures and outcomes for triage clinics. PMID:25410703

  5. Reno Orthopaedic Trauma Fellowship business curriculum. (United States)

    Althausen, Peter L; Bray, Timothy J; Hill, Austin D


    The Reno Orthopaedic Center (ROC) Trauma Fellowship business curriculum is designed to provide the fellow with a graduate level business practicum and research experience. The time commitments in a typical 12-month trauma fellowship are significant, rendering a traditional didactic master's in business administration difficult to complete during this short time. An organized, structured, practical business education can provide the trauma leaders of tomorrow with the knowledge and experience required to effectively navigate the convoluted and constantly changing healthcare system. The underlying principle throughout the curriculum is to provide the fellow with the practical knowledge to participate in cost-efficient improvements in healthcare delivery. Through the ROC Trauma Fellowship business curriculum, the fellow will learn that delivering healthcare in a manner that provides better outcomes for equal or lower costs is not only possible but a professional and ethical responsibility. However, instilling these values without providing actionable knowledge and programs would be insufficient and ineffective. For this reason, the core of the curriculum is based on individual teaching sessions with a wide array of hospital and private practice administrators. In addition, each section is equipped with a suggested reading list to maximize the learning experience. Upon completion of the curriculum, the fellow should be able to: (1) Participate in strategic planning at both the hospital and practice level based on analysis of financial and clinical data, (2) Understand the function of healthcare systems at both a macro and micro level, (3) Possess the knowledge and skills to be strong leaders and effective communicators in the business lexicon of healthcare, (4) Be a partner and innovator in the improvement of the delivery of orthopaedic services, (5) Combine scientific and strategic viewpoints to provide an evidence-based strategy for improving quality of care in a

  6. EO-1 Data Quality and Sensor Stability with Changing Orbital Precession at the End of a 16 Year Mission

    Directory of Open Access Journals (Sweden)

    Shannon Franks


    Full Text Available The Earth Observing One (EO-1 satellite has completed 16 years of Earth observations in early 2017. What started as a technology mission to test various new advancements turned into a science and application mission that extended many years beyond the satellite’s planned life expectancy. EO-1’s primary instruments are spectral imagers: Hyperion, the only civilian full spectrum spectrometer (430–2400 nm in orbit, and the Advanced Land Imager (ALI, the prototype for Landsat-8’s pushbroom imaging technology. Both Hyperion and ALI instruments have continued to perform well, but in February 2011, the satellite ran out of the fuel necessary to maintain orbit, which initiated a change in precession rate that led to increasingly earlier equatorial crossing times during its last five years. The change from EO-1’s original orbit, when it was formation flying with Landsat-7 at a 10:01 a.m. equatorial overpass time, to earlier overpass times results in image acquisitions with increasing solar zenith angles (SZAs. This study takes several approaches to characterize data quality as SZAs increased. The results show that for both EO-1 sensors, atmospherically corrected reflectance products, are within 5 to 10% of mean pre-drift products. No marked trend in decreasing quality in ALI or Hyperion is apparent through 2016, and these data remain a high quality resource through the end of the mission.

  7. Nanostructured diamond coatings for orthopaedic applications (United States)



    With increasing numbers of orthopaedic devices being implanted, greater emphasis is being placed on ceramic coating technology to reduce friction and wear in mating total joint replacement components, in order to improve implant function and increase device lifespan. In this chapter, we consider ultra-hard carbon coatings, with emphasis on nanostructured diamond, as alternative bearing surfaces for metallic components. Such coatings have great potential for use in biomedical implants as a result of their extreme hardness, wear resistance, low friction and biocompatibility. These ultra-hard carbon coatings can be deposited by several techniques resulting in a wide variety of structures and properties. PMID:25285213

  8. Modeling and performance assessment in QinetiQ of EO and IR airborne reconnaissance systems (United States)

    Williams, John W.; Potter, Gary E.


    QinetiQ are the technical authority responsible for specifying the performance requirements for the procurement of airborne reconnaissance systems, on behalf of the UK MoD. They are also responsible for acceptance of delivered systems, overseeing and verifying the installed system performance as predicted and then assessed by the contractor. Measures of functional capability are central to these activities. The conduct of these activities utilises the broad technical insight and wide range of analysis tools and models available within QinetiQ. This paper focuses on the tools, methods and models that are applicable to systems based on EO and IR sensors. The tools, methods and models are described, and representative output for systems that QinetiQ has been responsible for is presented. The principle capability applicable to EO and IR airborne reconnaissance systems is the STAR (Simulation Tools for Airborne Reconnaissance) suite of models. STAR generates predictions of performance measures such as GRD (Ground Resolved Distance) and GIQE (General Image Quality) NIIRS (National Imagery Interpretation Rating Scales). It also generates images representing sensor output, using the scene generation software CAMEO-SIM and the imaging sensor model EMERALD. The simulated image 'quality' is fully correlated with the predicted non-imaging performance measures. STAR also generates image and table data that is compliant with STANAG 7023, which may be used to test ground station functionality.

  9. XML DTD and Schemas for HDF-EOS (United States)

    Ullman, Richard; Yang, Jingli


    An Extensible Markup Language (XML) document type definition (DTD) standard for the structure and contents of HDF-EOS files and their contents, and an equivalent standard in the form of schemas, have been developed.

  10. Prevalence and pattern of small animal orthopaedic conditions at ...

    African Journals Online (AJOL)

    Small animal orthopaedic case records of a 20-year period were surveyed to obtain the prevalence and pattern of orthopaedic conditions presented to the Veterinary Teaching Hospital (VTH), University of Ibadan, Nigeria, with the objective of providing data for planning on small animal healthcare facilities, policy ...

  11. Overview of Blood Transfusion in Orthopaedic Trauma in Ilorin ...

    African Journals Online (AJOL)

    Background: Blood transfusion in orthopaedic trauma is very important, its safety and risks are to be balanced. Objective: To determine the blood transfusion rate of orthopaedic trauma requiring operations. Method: All patients admitted to Ela Memorial Medical Centre, Ilorin from 1st January, 2001 to 31st May 2006 were ...

  12. About the beginnings of orthopaedics in Timisoara. (United States)

    Poenaru, Dan V


    The historical and geographical territory of Banat is part of present-day Romania. Timisoara's history, the capital city of Banat region, dates back to the second century B.C. Medical life in Banat was re-organised after the promulgation of the Aulic Laws in the eighteenth century. Thorough research was undertaken through historic manuscripts, old newspapers, biographies and other papers about the history of Romanian medicine. The eighteenth century witnessed the building of three hospitals in Timisoara. In that period, Banat region benefited from the expertise and professionalism of doctors who graduated and were trained mainly in Central and Western European universities. By the beginning of the twentieth century, many medical clinics or sanatoriums specialising in orthopaedics and traumatology were offering their services to the population. Banat region had many good orthopaedists, and one of them was Prof. Dr. Doc. Berceanu, who graduated from the University of Medicine Bucharest and further specialised in Paris, France. He is the founder of the Orthopaedics and Traumatology Clinic in Timisoara.

  13. Energy Referencing in LANL HE-EOS Codes

    Energy Technology Data Exchange (ETDEWEB)

    Leiding, Jeffery Allen [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Coe, Joshua Damon [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)


    Here, We briefly describe the choice of energy referencing in LANL's HE-EOS codes, HEOS and MAGPIE. Understanding this is essential to comparing energies produced by different EOS codes, as well as to the correct calculation of shock Hugoniots of HEs and other materials. In all equations after (3) throughout this report, all energies, enthalpies and volumes are assumed to be molar quantities.

  14. Radiation Exposure and Health Risks for Orthopaedic Surgeons. (United States)

    Hayda, Roman A; Hsu, Raymond Y; DePasse, J Mason; Gil, Joseph A


    Orthopaedic surgeons are routinely exposed to intraoperative radiation and, therefore, follow the principle of "as low as reasonably achievable" with regard to occupational safety. However, standardized education on the long-term health effects of radiation and the basis for current radiation exposure limits is limited in the field of orthopaedics. Much of orthopaedic surgeons' understanding of radiation exposure limits is extrapolated from studies of survivors of the atomic bombings in Hiroshima and Nagasaki, Japan. Epidemiologic studies on cancer risk in surgeons and interventional proceduralists and dosimetry studies on true radiation exposure during trauma and spine surgery recently have been conducted. Orthopaedic surgeons should understand the basics and basis of radiation exposure limits, be familiar with the current literature on the incidence of solid tumors and cataracts in orthopaedic surgeons, and understand the evidence behind current intraoperative fluoroscopy safety recommendations.

  15. A Clinico- Epidemiological Study Of Filarial Related Orthopaedic Manifestations

    Directory of Open Access Journals (Sweden)

    Patond K.R


    Full Text Available An epidemiological study was undertaken to study the incidence and distribution of orthopaedic manifestations of filariasis in an endemic area. A total of 207 cases were clinically examined and investigated. Patients were divided into three groups , viz., Group A: Orthopaedic manifestations with no history of filariasis . Group B: Orthopaedic manifestations with history of filariasis such as microfilaraemia or filarial fevers etc., Group C: Orthopaedic manifestations with chronic manifestations such as elephantiasis, hydrocele etc. To confirm filarial etiology, all the cases were examined for the presence of filarial antibody by indirect ELISA using wuchereda bancrofti microfilarial excretory- secretary antigen (wd Mf ESAg . A total of 61 of 102 patients of Group A, 14 of 21 patients of group B, and 73 of 84 patients of Group C were positive for filarial antibody. This study showed the prevalence of filarial antibody in about 71.4% of various orthopaedic manifestations.

  16. Clinical application of helical CT 3D reconstruction for the dental orthopaedics

    International Nuclear Information System (INIS)

    Han Benyi; Jiang Xiaolu; Li Hongru


    Objective: To evaluate the clinical application of helical CT 3D reconstruction technique in the dental orthopaedics. Methods: The helical CT was performed with 3.0 mm slice thickness and 1.0 pitch in 41 patients with dental orthopaedics. The 3D reconstructions, including maximum intensity projection (MIP), surface shaded display (SSD), and multiplanar reconstructions (MPR), were made for all the cases. Results: Thirty-seven of the 41 patients showed malalignment, tilt, rotation, overlap of the teeth and the different space between the longitudinal axes of the teeth. Twenty-five cases of them have shown 36 buried teeth in all. The axial images covered all the information. SSD demonstrated the external contours and entire morphologies of the teeth and the mandible with the relationship of the teeth alignment and the mandible. MIP clearly manifested the full view and the longitudinal alignment of the teeth. Among the 36 buried teeth, there were 29 palatally and 7 labially presented teeth, and they were morphologically delineated on MIP through various angles. Conclusion: The helical CT 3D reconstruction is a new technique to display the stereoscopic configuration of teeth. The combination of axial images and MIP, SSD, and MPR provides valuable anatomic and diagnostic information helpful for the surgeons to structure and determine the treatment protocol for the dental orthopaedics. (authors)

  17. Opacplot2: Enabling tabulated EoS and opacity compatibility for HEDLP simulations with the FLASH code (United States)

    Laune, Jordan; Tzeferacos, Petros; Feister, Scott; Fatenejad, Milad; Yurchak, Roman; Flocke, Norbert; Weide, Klaus; Lamb, Donald


    Thermodynamic and opacity properties of materials are necessary to accurately simulate laser-driven laboratory experiments. Such data are compiled in tabular format since the thermodynamic range that needs to be covered cannot be described with one single theoretical model. Moreover, tabulated data can be made available prior to runtime, reducing both compute cost and code complexity. This approach is employed by the FLASH code. Equation of state (EoS) and opacity data comes in various formats, matrix-layouts, and file-structures. We discuss recent developments on opacplot2, an open-source Python module that manipulates tabulated EoS and opacity data. We present software that builds upon opacplot2 and enables easy-to-use conversion of different table formats into the IONMIX format, the native tabular input used by FLASH. Our work enables FLASH users to take advantage of a wider range of accurate EoS and opacity tables in simulating HELP experiments at the National Laser User Facilities.

  18. Thromboembolism prophylaxis practices in orthopaedic arthroplasty patients.

    LENUS (Irish Health Repository)

    Cawley, D


    Thromboembolic events are a post-operative complication of arthroplasty surgery for up to 3 months. The incidence however, is not fully known. Some form of prophylaxis should be provided to all arthroplasty patients. Clinicians are wary of side effects, compliance profile and the associated cost. The objective of this study is to investigate practice patterns and their relevance to 3 risk groups. Ninety questionnaires were sent to orthopaedic surgeons with 3 hypothetical clinical scenarios and 10 prophylaxis regimes for thromboembolism across different risk groups. The response rate was 81\\/90 (90%). The most popular options in all 3 cases were early mobilisation, thrombo-embolism deterrant (TED) stockings and low molecular weight heparin (LMWH) (51\\/81, 62% of all cases). An inconsistent relationship exists between preferred practice and relevant guidelines. Preferred practice does not correlate with each level of risk.

  19. Perioperative blood transfusions in orthopaedic surgery. (United States)

    Ponnusamy, Karthikeyan E; Kim, Thomas J; Khanuja, Harpal S


    Blood transfusion after orthopaedic surgery accounts for 10% of all packed red blood-cell transfusions, but use varies substantially across hospitals and surgeons. Transfusions can cause systemic complications, including allergic reactions, transfusion-related acute lung injury, transfusion-associated circulatory overload, graft-versus-host disease, and infections. Tranexamic acid is a new cost-effective blood management tool to reduce blood loss and decrease the risk of transfusion after total joint arthroplasty. Current clinical evidence does not justify transfusions for a hemoglobin level of >8 g/dL in the absence of symptoms. Studies have also supported the use of this trigger in patients with a history or risk of cardiovascular disease. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

  20. Radiation exposure to the eye lens of orthopaedic surgeons during various orthopaedic procedures

    International Nuclear Information System (INIS)

    Romanova, K.; Alyakov, M.; Vassileva, J.


    The aim of the present study was to assess the radiation dose to the eye lens of orthopaedic surgeons during various orthopaedic procedures and to make efforts to ensure that radiation protection is optimised. The study was performed for Fractura femoris and Fractura cruris procedures performed in orthopaedic operating theatres, as well as for fractures of wrist, ankle and hand/ shoulder performed in the emergency trauma room. The highest mean value of the eye lens dose of 47.2 μSv and higher mean fluoroscopy time of 3 min, as well as the corresponding highest maximum values of 77.1 μSv and 5.0 min were observed for the Fractura femoris procedure performed with the Biplanar 500e fluoroscopy systems. At a normal workload, the estimated mean annual dose values do not exceed the annual occupational dose limit for the lens of eye, but at a heavy workload in the department, this dose limit could be achieved or exceeded. The use of protective lead glasses is recommended as they could reduce the radiation exposure of the lens of the eye. The phantom measurements demonstrated that the use of half-dose mode could additionally reduce dose to the operator's eye lens. (authors)

  1. Exponential 6 parameterization for the JCZ3-EOS

    Energy Technology Data Exchange (ETDEWEB)

    McGee, B.C.; Hobbs, M.L.; Baer, M.R.


    A database has been created for use with the Jacobs-Cowperthwaite-Zwisler-3 equation-of-state (JCZ3-EOS) to determine thermochemical equilibrium for detonation and expansion states of energetic materials. The JCZ3-EOS uses the exponential 6 intermolecular potential function to describe interactions between molecules. All product species are characterized by r*, the radius of the minimum pair potential energy, and {var_epsilon}/k, the well depth energy normalized by Boltzmann`s constant. These parameters constitute the JCZS (S for Sandia) EOS database describing 750 gases (including all the gases in the JANNAF tables), and have been obtained by using Lennard-Jones potential parameters, a corresponding states theory, pure liquid shock Hugoniot data, and fit values using an empirical EOS. This database can be used with the CHEETAH 1.40 or CHEETAH 2.0 interface to the TIGER computer program that predicts the equilibrium state of gas- and condensed-phase product species. The large JCZS-EOS database permits intermolecular potential based equilibrium calculations of energetic materials with complex elemental composition.

  2. Global EOS: exploring the 300-ms-latency region (United States)

    Mascetti, L.; Jericho, D.; Hsu, C.-Y.


    EOS, the CERN open-source distributed disk storage system, provides the highperformance storage solution for HEP analysis and the back-end for various work-flows. Recently EOS became the back-end of CERNBox, the cloud synchronisation service for CERN users. EOS can be used to take advantage of wide-area distributed installations: for the last few years CERN EOS uses a common deployment across two computer centres (Geneva-Meyrin and Budapest-Wigner) about 1,000 km apart (∼20-ms latency) with about 200 PB of disk (JBOD). In late 2015, the CERN-IT Storage group and AARNET (Australia) set-up a challenging R&D project: a single EOS instance between CERN and AARNET with more than 300ms latency (16,500 km apart). This paper will report about the success in deploy and run a distributed storage system between Europe (Geneva, Budapest), Australia (Melbourne) and later in Asia (ASGC Taipei), allowing different type of data placement and data access across these four sites.


    Directory of Open Access Journals (Sweden)

    E. M. Polyakova


    Full Text Available Review brief presents description of polymerase chain reaction method (PCR and its most common variants. Three PCR-based lines of research, carried out in the traumatology and orthopaedics, include identifying a causative agents of the implant-associated infection after orthopaedic surgery; detection of antibiotic resistance genes and biofilm forming genes. It was shown that PCR can be used as additional method for detection of genetic disorders, significant for traumatology and orthopaedics, and for investigation of cartilage and bone regeneration.

  4. Atypical Clavicular Involvement of Nonbacterial Osteitis: An Orthopaedic Enigma

    Directory of Open Access Journals (Sweden)

    Salil Umrani


    Full Text Available Nonbacterial osteitis (NBO is an underdiagnosed and poorly understood condition caused by sterile inflammation. It can mimic the presentation of many other orthopaedic conditions, for example, osteomyelitis, septic arthritis, or malignancy, in particular for those patients who have unifocal presentation. Because NBO is a diagnosis by exclusion, it poses much difficulty and confusion to many orthopaedic surgeons in treating such disease. Clavicular involvement is common but it is typically present at the medial aspect of the clavicle. We report a case of NBO with atypical clavicular involvement who presented to our orthopaedic clinic with painful swelling in the left shoulder. Appropriate investigations and management are discussed together with literature review.

  5. Surface retrievals from Hyperion EO1 using a new, fast, 1D-Var based retrieval code (United States)

    Thelen, Jean-Claude; Havemann, Stephan; Wong, Gerald


    We have developed a new algorithm for the simultaneous retrieval of the atmospheric profiles (temperature, humidity, ozone and aerosol) and the surface reflectance from hyperspectral radiance measurements obtained from air/space-borne, hyperspectral imagers such as Hyperion EO-1. The new scheme, proposed here, consists of a fast radiative transfer code, based on empirical orthogonal functions (EOFs), in conjunction with a 1D-Var retrieval scheme. The inclusion of an 'exact' scattering code based on spherical harmonics, allows for an accurate treatment of Rayleigh scattering and scattering by aerosols, water droplets and ice-crystals, thus making it possible to also retrieve cloud and aerosol optical properties, although here we will concentrate on non-cloudy scenes. We successfully tested this new approach using hyperspectral images taken by Hyperion EO-1, an experimental pushbroom imaging spectrometer operated by NASA.

  6. Strategic planning in a highly specialized orthopaedic institution

    Directory of Open Access Journals (Sweden)

    Vukašinović Zoran


    Full Text Available Introduction. The Institute for Orthopaedic Surgery 'Banjica' in Belgrade provides tertiary healthcare services on national level. After decades of constant development, a recent decline coincided with the decade of great social and governmental disturbance, the transition period after the dissociation of former Yugoslavia. Objective. In order to overcome the crisis, we used modern management methods to define problems in the institution management, and to propose appropriate strategies. Methods. A survey that included 100 employees (17.67% was carried out, followed by descriptive statistical analysis, PEST and SWOT analyses. Results The impact of political fluctuations, ageing of population, financing model, obsolete medical technology was evaluated. Various personal and interpersonal factors were assessed: the quality of medical service (3.59±0.76, mark 1-5; relations among health service participants (3.39±0.78; occupational conditions (not good-91%; human, financial and other resources; professional cooperation, stimulation; rivalry and mobbing (declared in 56%; public informing, institution image (rank 3.70±0.88 and PR activities (new to 78%. 93% declared to give maximum effort at work. Conclusion. Using these results, we defined several strategic objectives. These include strengthening scientific activities, general orientation to specific and exclusive pathological conditions and treatment methods, improvement of management transparency, introduction of quality-based stimulation of workers, support of promotional and PR activities.

  7. Strategic planning in a highly specialized orthopaedic institution. (United States)

    Vukasinović, Zoran; Bjegović-Mikanović, Vesna; Jancić, Radmila; Spasovski, Dusko; Zivković, Zorica; Cerović, Sofija; Terzić, Zorica


    The Institute for Orthopaedic Surgery "Banjica" in Belgrade provides tertiary healthcare services on national level. After decades of constant development, a recent decline coincided with the decade of great social and governmental disturbance, the transition period after the dissociation of former Yugoslavia. In order to overcome the crisis, we used modern management methods to define problems in the institution management, and to propose appropriate strategies. A survey that included 100 employees (17.67%) was carried out, followed by descriptive statistical analysis, PEST and SWOT analyses. The impact of political fluctuations, ageing of population, financing model, obsolete medical technology was evaluated. Various personal and interpersonal factors were assessed: the quality of medical service (3.59 +/- 0.76, mark 1-5); relations among health service participants (3.39 +/- 0.78); occupational conditions (not good-91%); human, financial and other resources; professional cooperation, stimulation; rivalry and mobbing (declared in 56%); public informing, institution image (rank 3.70 +/- 0.88) and PR activities (new to 78%). 93% declared to give maximum effort at work. Using these results, we defined several strategic objectives. These include strengthening scientific activities, general orientation to specific and exclusive pathological conditions and treatment methods, improvement of management transparency, introduction of quality-based stimulation of workers, support of promotional and PR activities.


    African Journals Online (AJOL)

    outcome and success rates. The none surgical modalities available include medications, injections preolytic. LOW BACK PAINS –THE ORTHOPAEDIC SURGEON'S ENIGMA enzymes, laser therapy, radiofrequency denervation, intradiscal electro thermal therapy, percutaneous intradiscal radiofrequency thermoregulation ...

  9. Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures. (United States)

    Watters, William; Rethman, Michael P; Hanson, Nicholas Buck; Abt, Elliot; Anderson, Paul A; Carroll, Karen C; Futrell, Harry C; Garvin, Kevin; Glenn, Stephen O; Hellstein, John; Hewlett, Angela; Kolessar, David; Moucha, Calin; O'Donnell, Richard J; O'Toole, John E; Osmon, Douglas R; Evans, Richard Parker; Rinella, Anthony; Steinberg, Mark J; Goldberg, Michael; Ristic, Helen; Boyer, Kevin; Sluka, Patrick; Martin, William Robert; Cummins, Deborah S; Song, Sharon; Woznica, Anne; Gross, Leeaht


    The Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures evidence-based clinical practice guideline was codeveloped by the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association. This guideline replaces the previous AAOS Information Statement, "Antibiotic Prophylaxis in Bacteremia in Patients With Joint Replacement," published in 2009. Based on the best current evidence and a systematic review of published studies, three recommendations have been created to guide clinical practice in the prevention of orthopaedic implant infections in patients undergoing dental procedures. The first recommendation is graded as Limited; this recommendation proposes that the practitioner consider changing the long-standing practice of routinely prescribing prophylactic antibiotic for patients with orthopaedic implants who undergo dental procedures. The second, graded as Inconclusive, addresses the use of oral topical antimicrobials in the prevention of periprosthetic joint infections. The third recommendation, a Consensus statement, addresses the maintenance of good oral hygiene.

  10. Understanding and Addressing the Global Need for Orthopaedic Trauma Care. (United States)

    Agarwal-Harding, Kiran J; von Keudell, Arvind; Zirkle, Lewis G; Meara, John G; Dyer, George S M


    ➤The burden of musculoskeletal trauma is high worldwide, disproportionately affecting the poor, who have the least access to quality orthopaedic trauma care.➤Orthopaedic trauma care is essential, and must be a priority in the horizontal development of global health systems.➤The education of surgeons, nonphysician clinicians, and ancillary staff in low and middle income countries is central to improving access to and quality of care.➤Volunteer surgical missions from rich countries can sustainably expand and strengthen orthopaedic trauma care only when they serve a local need and build local capacity.➤Innovative business models may help to pay for care of the poor. Examples include reducing costs through process improvements and cross-subsidizing from profitable high-volume activities.➤Resource-poor settings may foster innovations in devices or systems with universal applicability in orthopaedics. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

  11. East African Orthopaedic Journal - Vol 6, No 2 (2012)

    African Journals Online (AJOL)

    Epidural injection use for low back pain associated with sciatica at an Orthopaedic centre in Kenya · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. JK Kingori, LN Gakuu, 60-62 ...

  12. Concussion in Sports: What Do Orthopaedic Surgeons Need to Know? (United States)

    Cahill, Patrick J; Refakis, Christian; Storey, Eileen; Warner, William C


    A concussion is a relatively common sports-related injury that affects athletes of all ages. Although orthopaedic surgeons are not expected to replace sports medicine physicians and neurologists with regard to the management of concussions, orthopaedic surgeons, particularly those who are fellowship-trained in sports medicine, must have a current knowledge base of what a concussion is, how a concussion is diagnosed, and how a concussion should be managed. Orthopaedic surgeons should understand the pathophysiology, assessment, and management of concussion so that they have a basic comprehension of this injury, which is at the forefront of the academic literature and North American media. This understanding will prepare orthopaedic surgeons to work in concert with and assist sports medicine physicians, athletic trainers, and physical therapists in providing comprehensive care for athletes with a concussion.

  13. Mission operations concepts for Earth Observing System (EOS) (United States)

    Kelly, Angelita C.; Taylor, Thomas D.; Hawkins, Frederick J.


    Mission operation concepts are described which are being used to evaluate and influence space and ground system designs and architectures with the goal of achieving successful, efficient, and cost-effective Earth Observing System (EOS) operations. Emphasis is given to the general characteristics and concepts developed for the EOS Space Measurement System, which uses a new series of polar-orbiting observatories. Data rates are given for various instruments. Some of the operations concepts which require a total system view are also examined, including command operations, data processing, data accountability, data archival, prelaunch testing and readiness, launch, performance monitoring and assessment, contingency operations, flight software maintenance, and security.

  14. Earth Observation Training and Education with ESA LearnEO! (United States)

    Byfield, Valborg; Mathieu, Pierre-Philippe; Dobson, Malcolm; Rosmorduc, Vinca; Del Frate, Fabio; Banks, Chris; Picchiani, Matteo


    For society to benefit fully from its investment in Earth observation, EO data must be accessible and familiar to a global community of users who have the skills, knowledge and understanding to use the observations appropriately in their work. Achieving this requires considerable education effort. LearnEO! ( is a new ESA education project that contributes towards making this a reality. LearnEO! has two main aims: to develop new training resources that use data from sensors on ESA satellites to explore a variety of environmental topics, and to stimulate and support members of the EO and education communities who may be willing to develop and share new education resources in the future. The project builds on the UNESCO Bilko project, which currently supplies free software, tutorials, and example data to users in 175 countries. Most of these users are in academic education or research, but the training resources are also of interest to a growing number of professionals in government, NGOs and private enterprise. Typical users are not remote sensing experts, but see satellite data as one of many observational tools. They want an easy, low-cost means to process, display and analyse data from different satellite sensors as part of their work in environmental research, monitoring and policy development. Many of the software improvements and training materials developed in LearnEO! are in response to requests from this user community. The LearnEO! tutorial and peer-reviewed lessons are designed to teach satellite data processing and analysis skills at different levels, from beginner to advanced - where advanced lessons requires some previous experience with Earth observation techniques. The materials are aimed at students and professionals in various branches of Earth sciences who have not yet specialised in specific EO technologies. The lessons are suitable for self-study, university courses at undergraduate to MSc level, or for continued professional

  15. Centaurus A galaxy, type EO peculiar elliptical, also radio source (United States)


    Centaurus A galaxy, type EO peculiar elliptical, also radio source. CTIO 4-meter telescope, 1975. NGC 5128, a Type EO peculiar elliptical galaxy in the constellation Centaurus. This galaxy is one of the most luminous and massive galaxies known and is a strong source of both radio and X-ray radiation. Current theories suggest that the nucleus is experiencing giant explosions involving millions of stars and that the dark band across the galactic disk is material being ejected outward. Cerro Toloto 4-meter telescope photo. Photo credit: National Optical Astronomy Observatories

  16. Quality Measures in Orthopaedic Sports Medicine: A Systematic Review. (United States)

    Abrams, Geoffrey D; Greenberg, Daniel R; Dragoo, Jason L; Safran, Marc R; Kamal, Robin N


    To report the current quality measures that are applicable to orthopaedic sports medicine physicians. Six databases were searched with a customized search term to identify quality measures relevant to orthopaedic sports medicine surgeons: MEDLINE/PubMed, EMBASE, the National Quality Forum (NQF) Quality Positioning System (QPS), the Agency for Healthcare Research and Quality (AHRQ) National Quality Measures Clearinghouse (NQMC), the Physician Quality Reporting System (PQRS) database, and the American Academy of Orthopaedic Surgeons (AAOS) website. Results were screened by 2 Board-certified orthopaedic surgeons with fellowship training in sports medicine and dichotomized based on sports medicine-specific or general orthopaedic (nonarthroplasty) categories. Hip and knee arthroplasty measures were excluded. Included quality measures were further categorized based on Donabedian's domains and the Center for Medicare and Medicaid (CMS) National Quality Strategy priorities. A total of 1,292 quality measures were screened and 66 unique quality measures were included. A total of 47 were sports medicine-specific and 19 related to the general practice of orthopaedics for a fellowship-trained sports medicine specialist. Nineteen (29%) quality measures were collected within PQRS, with 5 of them relating to sports medicine and 14 relating to general orthopaedics. AAOS Clinical Practice Guidelines (CPGs) comprised 40 (60%) of the included measures and were all within sports medicine. Five (8%) additional measures were collected within AHRQ and 2 (3%) within NQF. Most quality measures consist of process rather than outcome or structural measures. No measures addressing concussions were identified. There are many existing quality measures relating to the practice of orthopaedic sports medicine. Most quality measures are process measures described within PQRS or AAOS CPGs. Knowledge of quality measures are important as they may be used to improve care, are increasingly being used to

  17. Bone Adaptation Around Orthopaedic Implants of Varying Materials

    DEFF Research Database (Denmark)

    Bagge, Mette


    The bone adaptation around orthopaedic implants is simulated using a three-dimensional finite element model. The remodeling scheme has its origin in optimization methods, and includes anisotropy and time-dependent loading......The bone adaptation around orthopaedic implants is simulated using a three-dimensional finite element model. The remodeling scheme has its origin in optimization methods, and includes anisotropy and time-dependent loading...

  18. Smartphone apps for orthopaedic sports medicine - a smart move? (United States)

    Wong, Seng Juong; Robertson, Greg A; Connor, Katie L; Brady, Richard R; Wood, Alexander M


    With the advent of smartphones together with their downloadable applications (apps), there is increasing opportunities for doctors, including orthopaedic sports surgeons, to integrate such technology into clinical practice. However, the clinical reliability of these medical apps remains questionable. We reviewed available apps themed specifically towards Orthopaedic Sports Medicine and related conditions and assessed the level of medical professional involvement in their design and content, along with a review of these apps. The most popular smartphone app stores (Android, Apple, Blackberry, Windows, Samsung, Nokia) were searched for Orthopaedic Sports medicine themed apps, using the search terms; Orthopaedic Sports Medicine, Orthopaedics, Sports medicine, Knee Injury, Shoulder Injury, Anterior Cruciate Ligament Tear, Medial Collateral Ligament Tear, Rotator Cuff Tear, Meniscal Tear, Tennis Elbow. All English language apps related to orthopaedic sports medicine were included. A total of 76 individual Orthopaedic Sports Medicine themed apps were identified. According to app store classifications, there were 45 (59 %) medical themed apps, 28 (37 %) health and fitness themed apps, 1 (1 %) business app, 1 (1 %) reference app and 1 (1 %) sports app. Forty-nine (64 %) apps were available for download free of charge. For those that charged access, the prices ranged from £0.69 to £69.99. Only 51 % of sports medicine apps had customer satisfaction ratings and 39 % had named medical professional involvement in their development or content. We found the majority of Orthopaedic Sports Medicine apps had no named medical professional involvement, raising concerns over their content and evidence-base. We recommend increased regulation of such apps to improve the accountability of app content.

  19. The use and abuse of abbreviations in orthopaedic literature. (United States)

    Kilshaw, Michael J; Rooker, Jemma; Harding, Ian J


    Abbreviations are commonly used in medical literature. Their use has been associated with medical errors and they can be a source of irritation and misunderstanding. There are strict guidelines for their use. This study analysed the use of abbreviations in orthopaedic literature and compared adherence with guidelines in a general orthopaedic and spinal journal. It also examined orthopaedic professionals' understanding of abbreviations. The use of abbreviations in articles over a 3-month period in a general orthopaedic and spinal journal was analysed. The number of abbreviations and adherence with guidelines was recorded. A group of orthopaedic healthcare professionals were tested for their understanding of abbreviations. Almost half of all abbreviations were not properly used and 30% of abbreviations were never defined. Abbreviations were used significantly more often in the spinal journal. Only 40% of abbreviations were correctly defined by the orthopaedic professionals tested. Guidelines regarding the use of abbreviations are not being adhered to by authors or editors. The poor understanding of abbreviations underlines the importance of minimising their use and defining abbreviations when they are used.

  20. Accuracy of spinal orthopaedic tests: a systematic review

    Directory of Open Access Journals (Sweden)

    Gemmell Hugh


    Full Text Available Abstract Background The purpose of this systematic review was to critically appraise the literature on the accuracy of orthopaedic tests for the spine. Methods Multiple orthopaedic texts were reviewed to produce a comprehensive list of spine orthopaedic test names and synonyms. A search was conducted in MEDLINE, MANTIS, CINAHL, AMED and the Cochrane Library for relevant articles from inception up to December 2005. The studies were evaluated using the tool for quality assessment for diagnostic accuracy studies (QUADAS. Results Twenty-one papers met the inclusion criteria. The QUADAS scores ranged from 4 to 12 of a possible 14. Twenty-nine percent of the studies achieved a score of 10 or more. The papers covered a wide range of tests for spine conditions. Conclusion There was a lack of quantity and quality of orthopaedic tests for the spine found in the literature. There is a lack of high quality research regarding the accuracy of spinal orthopaedic tests. Due to this lack of evidence it is suggested that over-reliance on single orthopaedic tests is not appropriate.

  1. The American Orthopaedic Association-Japanese Orthopaedic Association 2010 traveling fellowship. (United States)

    Patel, Alpesh A; Cheng, Ivan; Yao, Jeffrey; Huffman, G Russell


    We started this journey excited by the prospects of visiting Japan, a country with a proud and historic past. We ended the fellowship accomplishing those goals, and we left with a great deal of admiration for our orthopaedic colleagues halfway around the world for their excellence in education, clinical care, and research. Their hospitality and attention to the details of our visit were exemplary and a lesson to us as we host visiting fellows in the future. Japan reflects its past, but it also offers a preview into our own nation's future: an aging population, a shrinking workforce, a stagnant economy, nationalized health care, and a mushrooming national debt. Of all of these factors, it is the aging population that we, as orthopaedic surgeons, will be most acutely aware of and involved with. The degenerative disorders that affect elderly patients dominate the landscape of surgical care in Japan. Osteoporosis and osteopenia permeate many aspects of care across orthopaedic subspecialties. The surgeons in Japan are developing innovative and cost-effective means of treating the large volume of older patients within the fiscal constraints of a nationalized health-care system. We learned, and will continue to learn more, from Japan about the management of this growing patient population with its unique pathologies and challenges. With the recent natural disaster and ongoing safety concerns in Japan, the character and will of the people of Japan have been on display. Their courage and resolve combined with order and compassion are a testament to the nation's cultural identity. The seeds of the Traveling Fellowship were planted shortly after Japan's last wide-scale reconstruction, and the ties that have bound the JOA and the AOA together are strengthened through this trying time. We strongly urge our colleagues in the U.S. to help support the people, the physicians, and the health-care system of Japan through its most recent tribulations and offer them the same care and

  2. Computer Assisted Orthopaedic Surgery – CAOS

    Directory of Open Access Journals (Sweden)

    Enes M. Kanlić


    Full Text Available The use of computer navigation in orthopedic surgery allows for real time intraoperative feedback resulting in higher precision of bone cuts, better alignment of implants and extremities, easier fracture reductions, less radiation and better documentation than what is possible in classical orthopaedic procedures. There is no need for direct and repeated visualization of many anatomical landmarks (classical method in order to have good intraoperative orientation. Navigation technology depicts anatomy and position of "smart tools" on the screen allowing for high surgical precision (smaller number of outliers from desired goal and with less soft tissue dissection (minimally invasive surgery - MIS. As a result, there are more happy patients with less pain, faster recovery, better functional outcome and well positioned, long lasting implants. In general, navigation cases are longer on the average 10 to 20 minutes, special training is required and equipment is relatively expensive. CAOS applications in knee and hip joint replacement are discussed.

  3. Tissue engineering skeletal muscle for orthopaedic applications (United States)

    Payumo, Francis C.; Kim, Hyun D.; Sherling, Michael A.; Smith, Lee P.; Powell, Courtney; Wang, Xiao; Keeping, Hugh S.; Valentini, Robert F.; Vandenburgh, Herman H.


    With current technology, tissue-engineered skeletal muscle analogues (bioartificial muscles) generate too little active force to be clinically useful in orthopaedic applications. They have been engineered genetically with numerous transgenes (growth hormone, insulinlike growth factor-1, erythropoietin, vascular endothelial growth factor), and have been shown to deliver these therapeutic proteins either locally or systemically for months in vivo. Bone morphogenetic proteins belonging to the transforming growth factor-beta superfamily are osteoinductive molecules that drive the differentiation pathway of mesenchymal cells toward the chondroblastic or osteoblastic lineage, and stimulate bone formation in vivo. To determine whether skeletal muscle cells endogenously expressing bone morphogenetic proteins might serve as a vehicle for systemic bone morphogenetic protein delivery in vivo, proliferating skeletal myoblasts (C2C12) were transduced with a replication defective retrovirus containing the gene for recombinant human bone morphogenetic protein-6 (C2BMP-6). The C2BMP-6 cells constitutively expressed recombinant human bone morphogenetic protein-6 and synthesized bioactive recombinant human bone morphogenetic protein-6, based on increased alkaline phosphatase activity in coincubated mesenchymal cells. C2BMP-6 cells did not secrete soluble, bioactive recombinant human bone morphogenetic protein-6, but retained the bioactivity in the cell layer. Therefore, genetically-engineered skeletal muscle cells might serve as a platform for long-term delivery of osteoinductive bone morphogenetic proteins locally.

  4. EoW criteria for waste-derived aggregates

    NARCIS (Netherlands)

    Hjelmar, O.; Sloot, van der H.A.; Comans, R.N.J.; Wahlstrom, H.


    Waste-derived aggregates are being considered as possible candidates for development of End-of-Waste (EoW) criteria at European Union (EU) level in accordance with Article 6 (1) of the EU Waste Framework Directive (2008/98/EC) as a means of increasing the recovery of resources from waste. If a

  5. EOS Terra Terra Constellation Exit/Future Maneuver Plans Update (United States)

    Mantziaras, Dimitrios


    This EOS Terra Constellation Exit/Future Maneuver Plans Update presentation will discuss brief history of Terra EOM work; lifetime fuel estimates; baseline vs. proposed plan origin; resultant exit orbit; baseline vs. proposed exit plan; long term orbit altitude; revised lifetime proposal and fallback options.

  6. EOS Aqua: Mission Status at Earth Science Constellation (United States)

    Guit, Bill


    This is an EOS Aqua Mission Status presentation to be given at the MOWG meeting in Albuquerque NM. The topics to discus are: mission summary, spacecraft subsystems summary, recent and planned activities, inclination adjust maneuvers, propellant usage and lifetime estimate, and mission summary.

  7. Mission Status at Aura Science Team MOWG Meeting: EOS Aura (United States)

    Fisher, Dominic


    Presentation at the 24797-16 Earth Observing System (EOS) Aura Science Team Meeting (Mission Operations Work Group (MOWG)) at Rotterdam, Netherlands August 29, 2016. Presentation topics include mission summary, spacecraft subsystems summary, recent and planned activities, spacecraft anomalies, data capture, propellant usage and lifetime estimates, spacecraft maneuvers and ground track history, mission highlights and past spacecraft anomalies and reliability estimates.

  8. EOS Aura and Future Satellite Studies of the Ozone Layer (United States)

    Schoeberl, Mark R.


    The EOS Aura mission, launched in 2004, provides a comprehensive assessment of the stratospheric dynamics and chemistry. This talk will focus on results from Aura including the chemistry of polar ozone depletion. The data from Aura can be directly linked to UARS data to produce long term trends in stratospheric trace gases.

  9. Estimation of SARA fraction properties with the SRK EOS

    Energy Technology Data Exchange (ETDEWEB)

    Akbarzadeh, K.; Moshfeghian, M.; Ayatollahi, S. [Shiraz Univ., Shiraz (Iran, Islamic Republic of); Alboudwarej, H.; Yarranton, H. [Calgary Univ., AB (Canada)


    A newly developed form of the Soave-Redlich-Kwong (SRK) equation of state (EOS) with Peneloux correction was presented. The new EOS was developed to extend the SRK approach to crude oils. Consequently the proposed EOS can estimate the molar volumes and solubility parameters of the four solubility classes of bitumens and heavy oils. These included saturates, aromatics, resins and asphaltenes (SARA). In this study, asphaltenes were considered as polymer-like compounds of aggregates of monodisperse asphaltene monomers. Correlations were developed for the critical properties and acentric factor of each solubility class. The EOS predicted properties were tested against density measurements of SARA fractions from several bitumens. The objective was to determine the onset of asphaltene precipitation from bitumen when heptane is added. The agreement between the predicted and measured onsets was very good. It was concluded that asphaltenes have a low degree of association in bitumen and that the asphaltene monomer molar mass is about 1800 g/mol for asphaltenes from Western Canada sources. Future work will focus on predicting asphaltene precipitation for varying conditions. 35 refs., 7 tabs., 4 figs.

  10. EOS Operations Systems: EDOS Implemented Changes to Reduce Operations Costs (United States)

    Cordier, Guy R.; Gomez-Rosa, Carlos; McLemore, Bruce D.


    The authors describe in this paper the progress achieved to-date with the reengineering of the Earth Observing System (EOS) Data and Operations System (EDOS), the experience gained in the process and the ensuing reduction of ground systems operations costs. The reengineering effort included a major methodology change, applying to an existing schedule driven system, a data-driven system approach.

  11. Scaling the Pipe: NASA EOS Terra Data Systems at 10 (United States)

    Wolfe, Robert E.; Ramapriyan, Hampapuram K.


    Standard products from the five sensors on NASA's Earth Observing System's (EOS) Terra satellite are being used world-wide for earth science research and applications. This paper describes the evolution of the Terra data systems over the last decade in which the distributed systems that produce, archive and distribute high quality Terra data products were scaled by two orders of magnitude.

  12. Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) Ocean Color (OC) Regional Data (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  13. Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) Chlorophyll (CHL) Global Mapped Data (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  14. Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) Normalized Difference Vegetation Index Land Reflectance Global Binned Data (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  15. Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) Fluorescence Line Height (FLH) Global Mapped Data (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  16. Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) Euphotic Depth (ZLEE) Global Mapped Data (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  17. Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) Diffuse Attenuation Coefficient for Downwelling Irradiance (KD) Global Mapped Data (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  18. Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) Inherent Optical Properties (IOP) Global Mapped Data (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  19. Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) Particulate Organic Carbon (POC) Global Binned Data (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  20. Terra Moderate Resolution Imaging Spectroradiometer (MODIS) Quasi-Analytical Algorithm (QAA) Global Mapped Data (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  1. Terra Moderate Resolution Imaging Spectroradiometer (MODIS) Quasi-Analytical Algorithm (QAA) Global Binned Data (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  2. Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) Quasi-Analytical Algorithm (QAA) Global Mapped Data (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  3. Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) Quasi-Analytical Algorithm (QAA) Global Binned Data (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  4. Terra Moderate Resolution Imaging Spectroradiometer (MODIS) Photosynthetically Available Radiation (PAR) Global Binned Data, reprocesing v2018 (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  5. 221 Eos: A remnant of a partially differentiated parent body? (United States)

    Mothé-Diniz, T.; Carvano, J. M.


    The asteroid 221 Eos (K class), has been traditionally associated to CO/CV meteorites (Bell 1988). This association is based solely on spectral similarities with meteorites, and previously the best spectral analog to Eos was found to be the CO3 Warrenton (Burbine et al. 2001). The 52-color spectrum ( and the SMASSIR spectrum (Burbine and Binzel 2001) of 221 Eos in the NIR region, combined with the SMASSII spectrum (Bus and Binzel 2001) in the visible, has now been compared to the whole RELAB meteorites database ( updated on July 31, 2003. This comparison revealed a better spectral analog to Eos: the anomalous stone Divnoe, a primitive achondrite meteorite. Problems and implications of such match for the composition of Eos and its dynamical family will be discussed. This work has been supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq/Brasil. References: Bell, J.F. 1988. A Probable Asteroidal Parent Body for the CV or CO Chondrites. Meteoritics 23, 256. Burbine, T.H. and Binzel, R.P. Bus, S.J. and Clark, B.E. 2001. K asteroids and CO3/CV3 chondrites. Icarus 36, 245. Burbine, T.H. and Binzel, R.P. 2002. Small Main-Belt Asteroid Spectroscopic Survey in the Near-Infrared. Icarus 159, 468. Bus, S.J. and Binzel, R.P. 2002. Phase II of the Small Main-Belt Asteroid Spectroscopic Survey: The Observations. Icarus 158, 106.

  6. Rigorous theoretical constraint on constant negative EoS parameter [Formula: see text] and its effect for the late Universe. (United States)

    Burgazli, Alvina; Eingorn, Maxim; Zhuk, Alexander

    In this paper, we consider the Universe at the late stage of its evolution and deep inside the cell of uniformity. At these scales, the Universe is filled with inhomogeneously distributed discrete structures (galaxies, groups and clusters of galaxies). Supposing that the Universe contains also the cosmological constant and a perfect fluid with a negative constant equation of state (EoS) parameter [Formula: see text] (e.g., quintessence, phantom or frustrated network of topological defects), we investigate scalar perturbations of the Friedmann-Robertson-Walker metrics due to inhomogeneities. Our analysis shows that, to be compatible with the theory of scalar perturbations, this perfect fluid, first, should be clustered and, second, should have the EoS parameter [Formula: see text]. In particular, this value corresponds to the frustrated network of cosmic strings. Therefore, the frustrated network of domain walls with [Formula: see text] is ruled out. A perfect fluid with [Formula: see text] neither accelerates nor decelerates the Universe. We also obtain the equation for the nonrelativistic gravitational potential created by a system of inhomogeneities. Due to the perfect fluid with [Formula: see text], the physically reasonable solutions take place for flat, open and closed Universes. This perfect fluid is concentrated around the inhomogeneities and results in screening of the gravitational potential.

  7. Allergies in orthopaedic and trauma surgery. (United States)

    Lohmann, C H; Hameister, R; Singh, G


    Hypersensitivity reactions to implants in orthopaedic and trauma surgery are a rare but devastating complication. They are considered as a delayed-type of hypersensitivity reaction (type IV), characterized by an antigen activation of sensitized T-lymphocytes releasing various cytokines and may result in osteoclast activation and bone resorption. Potential haptens are originated from metal alloys or bone-cement. A meta-analysis has confirmed a higher probability of developing a metal hypersensitivity postoperatively and noted a greater risk of failed replacements compared to stable implants. Hypersensitivity to implants may present with a variety of symptoms such as pain, joint effusion, delayed wound/bone healing, persistent secretion, allergic dermatitis (localized or systemic), clicking noises, loss of joint function, instability and failure of the implant. Various diagnostic options have been offered, including patch testing, metal alloy patch testing, histology, lymphocyte transformation test (LTT), memory lymphocyte immunostimulation assay (MELISA), leukocyte migration inhibition test (LIF) and lymphocyte activation test (LAT). No significant differences between in vivo and in vitro methods have been found. Due to unconvincing evidence for screening methods, predictive tests are not recommended for routine performance. Infectious aetiology always needs to be excluded. As there is a lack of evidence on large-scale studies with regards to the optimal treatment option, management currently relies on individual case-by-case decisions. Several options for patients with (suspected) metal-related hypersensitivity exist and may include materials based on ceramic, titanium or oxinium or modified surfaces. Promising results have been reported, but long-term experience is lacking. More large-scaled studies are needed in this context. In patients with bone-cement hypersensitivity, the component suspected for hypersensitivity should be avoided. The development of

  8. Anisotropic dark energy transit cosmological models with time-dependent ω(t) and redshift-dependent ω(z) EoS parameter (United States)

    Maurya, Dinesh Chandra

    In the present paper, we have been investigated a new dark energy model in anisotropic Bianchi-type-I (B-I) space-time with redshift-dependent equation of state (EoS) parameter. The Einstein’s field equations have been solved by applying a variation-law for hyperbolic scale factor a(t) = [sinh(αt)] 1 n which provides a time-dependent deceleration parameter and time-dependent EoS parameter. We also have been found the redshift-dependent EoS parameter. The existing range of the dark energy EoS parameter ω for derived model is found to be in good agreement with the recent observations. The cosmological constant Λ is found to be a decreasing function of time and it approaches a small positive value at the present epoch which is collaborated by results from recent supernovae Ia observations. It has also been suggested that the dark energy that explains the observed accelerating universe may arise due to the contribution to the vacuum energy of the EoS in a time-dependent background. Geometric and Kinematic properties of the model and the behavior of the anisotropy of the dark energy have been discussed.

  9. EO-199, a specific antagonist of antiarrhythmic drugs: Assessment by binding experiments and in vivo studies

    Energy Technology Data Exchange (ETDEWEB)

    Oppenheimer, E.; Harel, G.; Lipinsky, D.; Sarne, Y. (Tel-Aviv Univ. (Israel))


    EO-199, a demethylated analog of the novel class I antiarrhythmic drug EO-122 was found to antagonize the antiarrhythmic activity of EO-122 and that of procainamide (Class I{sub A}). EO-199 did not block significantly the activity of a class I{sub B} antiarrhythmic agent, lidocaine. EO-199 also displaced the specific binding of ({sup 3}H)EO-122 to rate heart membranes similarly to procainamide whereas lidocaine did not. The correlation between binding experiments and pharmacological effects points to a possible subclassification of these drugs; the two chemical analogs EO-199 and EO-122, as well as procainamide (I{sub A}) but not lidocaine (I{sub B}), compete at the same site or the same state of the sodium channel. The availability of a specific antagonist might be useful for studying the mechanism of action of antiarrhythmic drugs as well as an antidote in cases of antiarrhythmics overdose intoxication.

  10. Army orthopaedic surgery residency program directors' selection criteria. (United States)

    Orr, Justin D; Hoffmann, Jeffrey D; Arrington, Edward D; Gerlinger, Tad L; Devine, John G; Belmont, Philip J


    Factors associated with successful selection in U.S. Army orthopaedic surgical programs are unreported. The current analysis includes survey data from all Army orthopaedic surgery residency program directors (PDs) to determine these factors. PDs at all Army orthopaedic surgery residency programs were provided 17 factors historically considered critical to successful selection and asked to rank order the factors as well as assign a level of importance to each. Results were collated and overall mean rankings are provided. PDs unanimously expressed that performance during the on-site orthopaedic surgery rotation at the individual program director's institution was most important. Respondents overwhelmingly reported that Steps 1 and 2 licensing exam scores were next most important, respectively. Survey data demonstrated that little importance was placed on letters of recommendation and personal statements. PDs made no discriminations based on allopathic or osteopathic degrees. The most important factors for Army orthopaedic surgery residency selection were clerkship performance at the individual PD's institution and licensing examination score performance. Army PDs consider both USMLE and COMLEX results, because Army programs have a higher percentage of successful osteopathic applicants.

  11. A review of obesity and orthopaedic surgery: the critical issues. (United States)

    Obalum, D C; Fiberesima, F; Eyesan, S U; Ogo, C N; Nzew, C; Mijinyawa, M


    Obesity is a growing concern in the health community because of the morbidities associated with it. There is a higher occurrence of many orthopaedic conditions among obese individuals than their non-obese counter parts. Obesity also worsens the progression of many of these orthopaedic conditions. Studies have shown that obesity may have negative impact on bone metabolism and may be implicated in the pathophysiology of some orthopaedic conditions like osteoporosis, fractures, osteoarthritis and many soft tissue ailments by both reduction in bone mass and elaboration of proinflammatory cytokines. These contribute to preponderance of musculoskeletal co-morbidities among obese patients. Critical peri-operative issues which include increased cardiopulmonary risks, issues of special equipment, instrumentation, surgical approach, patients' positioning and adjustments in medication should be acknowledged and meticulously addressed in operative management of orthopaedic conditions in obese patients. Surgeries in obese patients are fraught with operative challenges and post-operative complications than in the non-obese and a good knowledge of the critical issues in surgical management of obese patients is necessary to facilitate decision making as well as rendering of effective and efficient orthopaedic care.

  12. Orthopaedic admissions due to sports and recreation injuries.

    LENUS (Irish Health Repository)

    Delaney, R A


    The health benefits of exercise may be attenuated by sports and recreation related injury (SRI). Though the majority of SRI are mild and self-limiting, a significant number are serious and require orthopaedic intervention. The aims of this study were to assess the burden of these serious injuries on the orthopaedic inpatient service, and to investigate potential target areas for injury prevention. All 1,590 SRI seen in the ED over a 3-month period were analysed using the Patient Information Management System to determine which patients received inpatient orthopaedic care. The medical records of those 63 patients who required inpatient care under orthopaedics were reviewed and data collected on demographic features, history, operative procedure and theatre resources, and length of hospital stay. Data were analyzed using SPSS. SRI accounted for 12.3% of all ED presentations. The principal activities resulting in injury requiring orthopaedic care were soccer, hurling and informal play e.g. trampoline. Falls made up 37% of the overall mechanism of injury but 68% of the injuries severe enough to require operative management. Most operative procedures were performed as part of a routine day trauma list but 20% were performed out of hours. This group of injuries places a significant burden on a busy trauma service. Injury prevention measures such as public education regarding falls in sport may have a role in reducing this burden.

  13. Overcoming resistance to implementation of integrated care pathways in orthopaedics. (United States)

    Manning, Blaine T; Callahan, Charles D; Robinson, Brooke S; Adair, Daniel; Saleh, Khaled J


    The future of orthopaedic surgery will be shaped by unprecedented demographic and economic challenges, necessitating movement to so-called "second curve" innovations in the delivery of care. Implementation of integrated care pathways (ICPs) may be one solution to imminent cost and access pressures facing orthopaedic patients in this era of health-care accountability and reform. ICPs can lower costs and the duration of hospital stay while facilitating better outcomes through enhanced interspecialty communication. As with any innovation at the crossroads of paradigm change, implementation of integrated care pathways for orthopaedics may elicit surgeons' concern on a variety of grounds and on levels ranging from casual questioning to vehement opposition. No single method is always effective in promoting cooperation and adoption, so a combination of strategies offers the best chance of success. With a special focus on total joint replacement, we consider general patterns of resistance to change, styles of conflict, and specific issues that may underlie orthopaedic surgeon resistance to implementation of integrated care pathways. Methods to facilitate and sustain orthopaedic surgeon engagement in implementation of such pathways are discussed.

  14. Sources of information influencing decision-making in orthopaedic surgery - an international online survey of 1147 orthopaedic surgeons. (United States)

    Schulz, Arndt P; Jönsson, Anders; Kasch, Richard; Jettoo, Prithee; Bhandari, Mohit


    Manufacturers of implants and materials in the field of orthopaedics use significant amounts of funding to produce informational material to influence the decision-making process of orthopaedic surgeons with regards to choice between novel implants and techniques. It remains unclear how far orthopaedic surgeons are really influenced by the materials supplied by companies or whether other, evidence-based publications have a higher impact on their decision-making. The objective was to evaluate the subjective usefulness and usage of different sources of information upon which orthopaedic surgeons base their decisions when acquiring new implants or techniques. We undertook an online survey of 1174 orthopaedic surgeons worldwide (of whom n = 305 were head of their department). The questionnaire included 34 items. Sequences were randomized to reduce possible bias. Questions were closed or semi-open with single or multiple answers. The usage and relevance of different sources of information when learning about and selecting orthopaedic treatments were evaluated. Orthopaedic surgeons and trainees were targeted, and were only allowed to respond once over a period of two weeks. Baseline information included country of workplace, level of experience and orthopaedic subspecialisation. The results were statistically evaluated. Independent scientific proof had the highest influence on decisions for treatment while OEM (Original Equipment Manufacturer) driven activities like newsletters, white papers or workshops had the least impact. Comparison of answers from the three best-represented countries in this study (Germany, UK and USA) showed some significant differences: Scientific literature and congresses are significantly more important in the US than in the UK or Germany, although they are very important in all countries. Independent and peer-reviewed sources of information are preferred by surgeons when choosing between methods and implants. Manufacturers of medical devices in

  15. Spin states of asteroids in the Eos collisional family (United States)

    Hanuš, J.; Delbo', M.; Alí-Lagoa, V.; Bolin, B.; Jedicke, R.; Ďurech, J.; Cibulková, H.; Pravec, P.; Kušnirák, P.; Behrend, R.; Marchis, F.; Antonini, P.; Arnold, L.; Audejean, M.; Bachschmidt, M.; Bernasconi, L.; Brunetto, L.; Casulli, S.; Dymock, R.; Esseiva, N.; Esteban, M.; Gerteis, O.; de Groot, H.; Gully, H.; Hamanowa, Hiroko; Hamanowa, Hiromi; Krafft, P.; Lehký, M.; Manzini, F.; Michelet, J.; Morelle, E.; Oey, J.; Pilcher, F.; Reignier, F.; Roy, R.; Salom, P. A.; Warner, B. D.


    Eos family was created during a catastrophic impact about 1.3 Gyr ago. Rotation states of individual family members contain information about the history of the whole population. We aim to increase the number of asteroid shape models and rotation states within the Eos collision family, as well as to revise previously published shape models from the literature. Such results can be used to constrain theoretical collisional and evolution models of the family, or to estimate other physical parameters by a thermophysical modeling of the thermal infrared data. We use all available disk-integrated optical data (i.e., classical dense-in-time photometry obtained from public databases and through a large collaboration network as well as sparse-in-time individual measurements from a few sky surveys) as input for the convex inversion method, and derive 3D shape models of asteroids together with their rotation periods and orientations of rotation axes. We present updated shape models for 15 asteroids and new shape model determinations for 16 asteroids. Together with the already published models from the publicly available DAMIT database, we compiled a sample of 56 Eos family members with known shape models that we used in our analysis of physical properties within the family. Rotation states of asteroids smaller than ∼ 20 km are heavily influenced by the YORP effect, whilst the large objects more or less retained their rotation state properties since the family creation. Moreover, we also present a shape model and bulk density of asteroid (423) Diotima, an interloper in the Eos family, based on the disk-resolved data obtained by the Near InfraRed Camera (Nirc2) mounted on the W.M. Keck II telescope.

  16. The EOS and neutrino interactions in dense matter

    Energy Technology Data Exchange (ETDEWEB)

    Prakash, M.; Reddy, S. [Dept. of Physics and Astronomy, SUNY at Stony Brook, Stony Brook, NY (United States)


    The deleptonization and cooling times of a newly born neutron star depend on the equation of state (EOS) and neutrino opacities in dense matter. Through model calculations we show that effects of Pauli blocking and many-body correlations due to strong interactions reduce both the neutral and charged current neutrino cross sections by large factors compared to the case in which these effects are ignored. (orig.)

  17. Tactical EO/IE System for Ground Forces (United States)


    this thesis is based on these ideas. We will give the guidelines to a project manager or to a beginner in EW research about EO/IR system acquisition...1982 Syria vs Israel Syria: 1 Syria 5+ By Syria: 89 by 96+ Sparrow AIM-9G/L PYTHON Korea: 1 B- Kamchatka 1983 Korea vs USSR 0 0 747(KAL-(07) by AA-3 or

  18. Earth Observation for Biodiversity Assessment (EO-BA)

    CSIR Research Space (South Africa)

    Cho, Moses A


    Full Text Available in the Dukuduku coastal forest Earth Observation for Biodiversity Assessment (EO-BA) MA CHO, P DEBBA, R MATHIEU, A RAMOELO, L NAIDOO, H VAN DEVENTER, O MALAHLELA AND R MAIN CSIR Natural Resources and the Environment, Pretoria, South Africa PO Box 395..., Pretoria, South Africa, 0001 Email: ? THE ROLE OF EARTH OBSERVATION IN PROVIDING BIODIVERSITY INFORMATION Biodiversity encompasses four levels: genetic, species, ecosystem and functional diversities. By sustaining...

  19. Management approach recommendations. Earth Observatory Satellite system definition study (EOS) (United States)


    Management analyses and tradeoffs were performed to determine the most cost effective management approach for the Earth Observatory Satellite (EOS) Phase C/D. The basic objectives of the management approach are identified. Some of the subjects considered are as follows: (1) contract startup phase, (2) project management control system, (3) configuration management, (4) quality control and reliability engineering requirements, and (5) the parts procurement program.

  20. Status of the Multi-Angle SpectroRadiometer Instrument for EOS- AM1 and Its Application to Remote Sensing of Aerosols (United States)

    Diner, D. J.; Abdou, W. A.; Bruegge, C. J.; Conel, J. E.; Kahn, R. A.; Martonchik, J. V.; Paradise, S. R.; West, R. A.


    The Multi-Angle Imaging SpectroRadiometer (MISR) is being developed at JPL for the AM1 spacecraft in the Earth Observing System (EOS) series. This paper reports on the progress of instrument fabrication and testing, and it discusses the strategy to use the instrument for studying tropospheric aerosols.

  1. Terra Moderate Resolution Imaging Spectroradiometer (MODIS) Quasi-Analytical Algorithm (QAA) Global Binned Data, reprocesing v2018 (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  2. Terra Moderate Resolution Imaging Spectroradiometer (MODIS) Quasi-Analytical Algorithm (QAA) Global Mapped Data, reprocesing v2018 (United States)

    National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

  3. Teleconsultation in paediatric orthopaedics in Djibouti: evaluation of response performance. (United States)

    Bertani, A; Launay, F; Candoni, P; Mathieu, L; Rongieras, F; Chauvin, F


    Djibouti has no paediatric orthopaedics department and three options are available for difficult cases: transfer of the patient to another country; overseas mission transfer to Djibouti by a specialised surgical team; and management by a local orthopaedic surgeon receiving guidance from an expert. The extreme poverty of part of the population of Djibouti often precludes the first two options. Telemedecine can allow the local orthopaedic surgeon to receive expert advice. HYPOTHESES AND STUDY DESIGN: We prospectively recorded all the paediatric orthopaedics teleconsultations that occurred between November 2009 and November 2011. Our objective was to assess the performance of the teleconsultations. We hypothetized that this option was influential in decision making. We assessed the influence of the teleconsultation on patient management (i.e., change in the surgical indication and/or procedure). We then used the electronic patient records to compare the actual management to that recommended retrospectively by two independent orthopaedic surgeon consultants who had experience working overseas. Finally, we assessed the clinical outcomes in the patients. Of 48 teleconsultations for 39 patients, 13 dealt with diagnostic problems and 35 with therapeutic problems. The teleconsultation resolved the diagnostic uncertainties in 90% of cases. Advice from the expert modified the management in 37 (77%) teleconsultations; the change was related to the surgical indication in 18 cases, the surgical technique in 13 cases, and both in six cases. Agreement between the advice from the independent consultants and the treatment delivered by the local surgeon was 2.2/3. Clinical outcomes were good or very good in 31 (81%) of the 38 treated patients. This study establishes the feasibility and usefulness of paediatric orthopaedics teleconsultations in Djibouti. The introduction of telemedicine has changed our approach to challenges raised by patients in remote locations or precarious

  4. Using financial incentives to improve value in orthopaedics. (United States)

    Lansky, David; Nwachukwu, Benedict U; Bozic, Kevin J


    A variety of reforms to traditional approaches to provider payment and benefit design are being implemented in the United States. There is increasing interest in applying these financial incentives to orthopaedics, although it is unclear whether and to what extent they have been implemented and whether they increase quality or reduce costs. We reviewed and discussed physician- and patient-oriented financial incentives being implemented in orthopaedics, key challenges, and prerequisites to payment reform and value-driven payment policy in orthopaedics. We searched the MEDLINE database using as search terms various provider payment and consumer incentive models. We retrieved a total of 169 articles; none of these studies met the inclusion criteria. For incentive models known to the authors to be in use in orthopaedics but for which no peer-reviewed literature was found, we searched Google for further information. Provider financial incentives reviewed include payments for reporting, performance, and patient safety and episode payment. Patient incentives include tiered networks, value-based benefit design, reference pricing, and value-based purchasing. Reform of financial incentives for orthopaedic surgery is challenged by (1) lack of a payment/incentive model that has demonstrated reductions in cost trends and (2) the complex interrelation of current pay schemes in today's fragmented environment. Prerequisites to reform include (1) a reliable and complete data infrastructure; (2) new business structures to support cost sharing; and (3) a retooling of patient expectations. There is insufficient literature reporting the effects of various financial incentive models under implementation in orthopaedics to know whether they increase quality or reduce costs. National concerns about cost will continue to drive experimentation, and all anticipated innovations will require improved collaboration and data collection and reporting.

  5. Retracted Publications in Orthopaedics: Prevalence, Characteristics, and Trends. (United States)

    Rai, Rahul; Sabharwal, Sanjeev


    Retracted publications are a crucial, yet overlooked, issue in the scientific community. The purpose of our study was to assess the prevalence, characteristics, and trends of retracted publications in the field of orthopaedics. Five databases were utilized to identify retracted publications in orthopaedics. The cited articles were assessed for various characteristics, including reason for retraction, based on the Committee on Publication Ethics (COPE) guidelines and trends over time. From 1984 to June 4, 2016, 59 of 229,502 orthopaedic publications were retracted (3 per 10,000 articles). There was a spike in the prevalence (22 of 59) of retracted articles in 2015. When compared with the total number of retracted publications identified through PubMed, the field of orthopaedics represented 1.4% of all retracted publications. The original version of 47 of these 59 retracted publications was still available on the respective journal's web site; 14 (30%) of these were not noted as having been retracted. The mean time from electronic publication to retraction was 19.4 ± 23.3 months. The mean number of citations of a retracted publication after the date of retraction was 9.3 ± 19.3. Reasons for retraction included plagiarism (32%), misconduct (27%), redundant publication (22%), miscalculation or experimental error (8%), and unethical research (0%); the reason for retraction was not stated for 10% of the publications. There was no correlation between a journal's impact factor and the mean number of months to retraction (p = 0.564). While uncommon, the retraction of publications within the field of orthopaedics may be increasing. The most often cited reasons for retraction were plagiarism, misconduct, and redundant publication. Retracted articles continue to be cited in the literature after retraction. Greater awareness of the COPE guidelines within the orthopaedic community and more efficient means to prevent the citation of retracted articles are needed.

  6. 77 FR 66848 - Minimum Clinically Important Difference: An Outcome Metric in Orthopaedic Device Science and... (United States)


    ...] Minimum Clinically Important Difference: An Outcome Metric in Orthopaedic Device Science and Regulation... Clinically Important Difference: An Outcome Metric in Orthopaedic Device Science and Regulation.'' FDA is co... Engineering and Science [[Page 66849

  7. Patients’ expectations and actual use of custom-made orthopaedic shoes

    NARCIS (Netherlands)

    van Netten, Jaap J.; Jannink, M.J.A.; Hijmans, Juha M.; Geertzen, Jan H.B.; Postema, Klaas


    Objective: To investigate the association between patients’ expectations and the actual use of custom-made orthopaedic shoes. - Design: A prospective cohort study with internal comparison. - Setting: Twelve orthopaedic shoe companies. - Patients: During six months, consecutive patients who were

  8. Patients' expectations and actual use of custom-made orthopaedic shoes

    NARCIS (Netherlands)

    van Netten, Jaap J.; Jannink, Michiel J. A.; Hijmans, Juha M.; Geertzen, Jan H. B.; Postema, Klaas


    Objective: To investigate the association between patients' expectations and the actual use of custom-made orthopaedic shoes. Design: A prospective cohort study with internal comparison. Setting: Twelve orthopaedic shoe companies. Patients: During six months, consecutive patients who were provided

  9. Vapor-liquid, liquid-liquid and vapor-liquid-liquid equilibrium of binary and multicomponent systems with MEG modeling with the CPA EoS and an EoS/G(E) model

    DEFF Research Database (Denmark)

    Folas, Georgios; Kontogeorgis, Georgios; Michelsen, Michael Locht


    The cubic-plus-association (CPA) EoS is applied to multicomponent multiphase equilibria of systems containing MEG as a hydrate inhibitor. It is shown that the model provides very satisfactory prediction of the phase behavior for the systems tested. A more conventional engineering model for handli...

  10. Rapid electro-optical (EO) TPS development in a military environment (United States)

    McKechnie, James; Irwin, Alan; Gauntner, Thomas


    Santa Barbara Infrared, Inc. has deployed IRWindows as an Electro-Optical test development and execution environment for military Test Program Sets (TPS). Advantages of TPS development for EO systems in the IRWindows environment are seen compared to the TPS development in ATLAS. The advantages of the IRWindows environment are: 1. Faster learning curve (graphical user interface is easier than test line interface) 2. Faster TPS development time (real time changes and asset control interface allows for faster development) 3. Asset control panel allows user to control assets real time and monitor all asset functions during development 4. Unit Under Test (UUT) image viewer allows user to set test parameters like Region of Interest more easily and more precisely 5. Continuous mode tests (like MTF allows user to real time adjustments) 6. Open architecture for test modifications This paper will outline the details of how these advantages are utilized and how not only development time is decreased but also how test execution time can be minimized making traditionally long TPS run times on EO systems more efficient.

  11. Use of unmanned SAR and EO/IR sensor suites for monitoring wildfires (United States)

    Dunkel, R.; Saddler, R.; Doerry, A. W.


    Synthetic Aperture Radar (SAR) is a proven, effective tool to monitor and map changing topography in rapidly expanding wildfire disaster situations. The broad area coverage provided by SAR can be used to detail areas of fire damage while high-resolution imagery can be used to determine fire movement and possibly provide warning to areas in the fire's path. General Atomics Aeronautical Systems, Inc. (GA-ASI) recently collected data with an airborne Lynx SAR, operating in the Ku Band, in conjunction with a FLIR Systems Star Safire 380-HD Electrical-optical/Infrared (EO/IR) camera system on Southern California's Blue Cut Fire. The Blue Cut Fire began in the Cajon Pass East of Los Angeles and burned a total of 36,000 acres4 . GA-ASI was able to overfly the fire, map the area, and detail the current location, as well as additional areas where the fire was spreading. Image Analysts were able to review the collected data and provide valuable information regarding location and possible fire direction. Analysts also conducted fire damage assessments to determine which structures were lost or damaged in the Fire. The real-time analysis of SAR and EO/IR data collections has the potential to increase effectiveness of firefighting crews attempting to contain a dynamic wildfire significantly

  12. SenSyF Experience on Integration of EO Services in a Generic, Cloud-Based EO Exploitation Platform (United States)

    Almeida, Nuno; Catarino, Nuno; Gutierrez, Antonio; Grosso, Nuno; Andrade, Joao; Caumont, Herve; Goncalves, Pedro; Villa, Guillermo; Mangin, Antoine; Serra, Romain; Johnsen, Harald; Grydeland, Tom; Emsley, Stephen; Jauch, Eduardo; Moreno, Jose; Ruiz, Antonio


    SenSyF is a cloud-based data processing framework for EO- based services. It has been pioneer in addressing Big Data issues from the Earth Observation point of view, and is a precursor of several of the technologies and methodologies that will be deployed in ESA's Thematic Exploitation Platforms and other related systems.The SenSyF system focuses on developing fully automated data management, together with access to a processing and exploitation framework, including Earth Observation specific tools. SenSyF is both a development and validation platform for data intensive applications using Earth Observation data. With SenSyF, scientific, institutional or commercial institutions developing EO- based applications and services can take advantage of distributed computational and storage resources, tailored for applications dependent on big Earth Observation data, and without resorting to deep infrastructure and technological investments.This paper describes the integration process and the experience gathered from different EO Service providers during the project.

  13. Management of Spinal Tuberculosis - A Metropolitan City Based Survey Among Orthopaedic and Neurosurgeons

    International Nuclear Information System (INIS)

    Muhammad, T.


    Objective: To explore the core understanding of spinal tuberculosis and its current management plans by orthopaedics and neurosurgeons. Methods: The questionnaire-based study was conducted from July 2011 to November 2012 in Karachi and comprised consultant orthopaedics and neurosurgeons belonging to 4 private and 3 government tertiary care teaching hospitals and having a minimum five years of post-fellowship experience. A pre-designed questionnaire was used to explore the current practice in spinal tuberculosis regarding its clinical presentation, diagnosis and treatment. SPSS 15 was used for statistical analysis. Results: There were 48 subjects in the study; 24(50 percent) orthopaedic surgeons and 24(50 percent) neurosurgeons. According to 44(91.70 percent) respondents, common age for spinal tuberculosis was second and third decades of life, and 37(77.08 percent)reported refractory back pain with or without neurological deficits as the commonest clinical finding. Typical magnetic resonance imaging findings was the uniform observation of all the 48(100 percent) respondents. Diagnosis was made by histopathological findings by 39(81.25 percent) respondents. Anti-tuberculosis therapy was started empirically on the basis of clinical, laboratory and radiological findings by 33(68.75 percent) respondents. Those in favour of giving anti-tuberculosis therapy for 18 months were 32(66.7 percent) respondents, and 33(68.75 percent) thought surgery does not expedite recovery. Conclusion: Extremely variable tools of diagnosis and diversified approaches for the treatment are alarming signs for the possible development of resistant strains and complications of spinal tuberculosis. (author)

  14. Diabetic mouse model of orthopaedic implant-related Staphylococcus aureus infection. (United States)

    Lovati, Arianna B; Drago, Lorenzo; Monti, Lorenzo; De Vecchi, Elena; Previdi, Sara; Banfi, Giuseppe; Romanò, Carlo L


    Periprosthetic bacterial infections represent one of the most challenging orthopaedic complications that often require implant removal and surgical debridement and carry high social and economical costs. Diabetes is one of the most relevant risk factors of implant-related infection and its clinical occurrence is growing worldwide. The aim of the present study was to test a model of implant-related infection in the diabetic mouse, with a view to allow further investigation on the relative efficacy of prevention and treatment options in diabetic and non-diabetic individuals. A cohort of diabetic NOD/ShiLtJ mice was compared with non-diabetic CD1 mice as an in vivo model of S. aureus orthopaedic infection of bone and soft tissues after femur intramedullary pin implantation. We tested control and infected groups with 1×10(3) colony-forming units of S. aureus ATCC 25923 strain injected in the implant site. At 4 weeks post-inoculation, host response to infection, microbial biofilm formation, and bone damage were assessed by traditional diagnostic parameters (bacterial culture, C-reactive protein and white blood cell count), histological analysis and imaging techniques (micro computed tomography and scanning electron microscopy). Unlike the controls and the CD1 mice, all the diabetic mice challenged with a single inoculum of S. aureus displayed severe osteomyelitic changes around the implant. Our findings demonstrate for the first time that the diabetic mouse can be successfully used in a model of orthopaedic implant-related infection. Furthermore, the same bacteria inoculum induced periprosthetic infection in all the diabetic mice but not in the controls. This animal model of implant-related infection in diabetes may be a useful tool to test in vivo treatments in diabetic and non-diabetic individuals.

  15. Diabetic mouse model of orthopaedic implant-related Staphylococcus aureus infection.

    Directory of Open Access Journals (Sweden)

    Arianna B Lovati

    Full Text Available BACKGROUND: Periprosthetic bacterial infections represent one of the most challenging orthopaedic complications that often require implant removal and surgical debridement and carry high social and economical costs. Diabetes is one of the most relevant risk factors of implant-related infection and its clinical occurrence is growing worldwide. The aim of the present study was to test a model of implant-related infection in the diabetic mouse, with a view to allow further investigation on the relative efficacy of prevention and treatment options in diabetic and non-diabetic individuals. METHODOLOGY: A cohort of diabetic NOD/ShiLtJ mice was compared with non-diabetic CD1 mice as an in vivo model of S. aureus orthopaedic infection of bone and soft tissues after femur intramedullary pin implantation. We tested control and infected groups with 1×10(3 colony-forming units of S. aureus ATCC 25923 strain injected in the implant site. At 4 weeks post-inoculation, host response to infection, microbial biofilm formation, and bone damage were assessed by traditional diagnostic parameters (bacterial culture, C-reactive protein and white blood cell count, histological analysis and imaging techniques (micro computed tomography and scanning electron microscopy. RESULTS: Unlike the controls and the CD1 mice, all the diabetic mice challenged with a single inoculum of S. aureus displayed severe osteomyelitic changes around the implant. CONCLUSIONS: Our findings demonstrate for the first time that the diabetic mouse can be successfully used in a model of orthopaedic implant-related infection. Furthermore, the same bacteria inoculum induced periprosthetic infection in all the diabetic mice but not in the controls. This animal model of implant-related infection in diabetes may be a useful tool to test in vivo treatments in diabetic and non-diabetic individuals.

  16. Transient aphasia following spinal anaesthesia in an orthopaedic ...

    African Journals Online (AJOL)

    A 50-year-old male [American Society of Anesthesiologists (ASA) grade II] was scheduled for lower limb orthopaedic surgery. The subarachnoid space was localised with difficulty at L3/4 interspace and 3 ml of hyperbaric bupivacaine was given. Within a few minutes, the patient developed aphasia with a very high sensory ...

  17. 99m Tc-labeled heparin test in orthopaedic surgery

    Energy Technology Data Exchange (ETDEWEB)

    Bouvier, J.F.; Lafon, J.C.; Colin, M.; Chatelut, J.; Beaubatie, F. (Hopital Universitaire Dupuytren, Limoges (France))


    99m Tc-labeled heparin test was performed for early detection of phlebitis or pulmonary embolism after orthopaedic prothesis. Heparinic treatment and surgery per se were demonstrated to have no effect on the results. If this test demonstrates a statistical difference for pathologic patients, it is of greater value to consider ratio between rates before and after intervention.

  18. Compliance in Antibiotic Prophylaxis in Orthopaedics and Trauma ...

    African Journals Online (AJOL)

    Background: Surgical site infection is the surgeons' greatest enemy. The fear of this enemy is even heightened in orthopaedic surgical practice, because of the poor resistance of bone to infections and the consequences when such infection occurs, especially in implant surgeries. Antibiotic prophylaxis is one measure of ...

  19. Local corticosteroid injections: Rational use in common orthopaedic ...

    African Journals Online (AJOL)

    corticosteroid used depends on the discretion of the orthopaedic surgeon based on his/her previous experience or on the availability of the preparation. When administered locally, it is the solubility and not the plasma half life that influences the efficacy. It is therefore prudent to use in acute inflammatory conditions a more.

  20. Orthopaedic Complications of Sickle Cell Disease: A Review ...

    African Journals Online (AJOL)

    Sickle cell disease (SCD) is a genetic disorder of mutant haemoglobin. It is inherited as an autosomal recessive disorder and is common in the West Africa subregion. Many of its orthopaedic complications require surgical intervention and many of its diverse manifestations need to be differentiated from some surgical ...

  1. Non-Steroidal Anti Inflammatory Drugs Usage In Orthopaedics And ...

    African Journals Online (AJOL)

    Background: Non steroidal anti-inflammatory drugs NSAIDs) are a group of heterogeneous compounds with nti inflammatory, analgesic and often times anti pyretic roperties. They are weak organic acids and are the most commonly used drugs in Orthopaedic/Trauma practice. hey provide mild to moderate pain relief.

  2. Seroprevalence Of HIV Infection Among Orthopaedic And Plastic ...

    African Journals Online (AJOL)

    As the HIV pandemic continues to ravage every aspect of humanity, there is a need to document its incidence and prevalence in various medical subdivisions. This six-month study reports on the sero- prevalence of HIV infection among orthopaedic and plastic surgery in- patients. Out of a total of 121 patients screened using ...

  3. Are the claims made in orthopaedic print advertisements valid? (United States)

    Davidson, Donald J; Rankin, Kenneth S; Jensen, Cyrus D; Moverley, Robert; Reed, Mike R; Sprowson, Andrew P


    Advertisements are commonplace in orthopaedic journals and may influence the readership with claims of clinical and scientific fact. Since the last assessment of the claims made in orthopaedic print advertisements ten years ago, there have been legislative changes and media scrutiny which have shaped this practice. The purpose of this study is to re-evaluate these claims. Fifty claims from 50 advertisements were chosen randomly from six highly respected peer-reviewed orthopaedic journals (published July-December 2011). The evidence supporting each claim was assessed and validated by three orthopaedic surgeons. The assessors, blinded to product and company, rated the evidence and answered the following questions: Does the evidence as presented support the claim made in the advertisement and what is the quality of that evidence? Is the claim supported by enough evidence to influence your own clinical practice? Twenty-eight claims cited evidence from published literature, four from public presentations, 11 from manufacturer "data held on file" and seven had no supporting evidence. Only 12 claims were considered to have high-quality evidence and only 11 were considered well supported. A strong correlation was seen between the quality of evidence and strength of support (Spearman r = 0.945, p practice and this evidence should be sought by manufacturers wishing to market a successful product.

  4. Mortality among orthopaedic and traumatology admissions: a ten ...

    African Journals Online (AJOL)

    The death certificates and postmortem examination findings were used in conjunction with the medical records to arrive at the possible cause of death in the deceased patients. Frequency analysis was done using SPSS version 13. Results: Over this period, 2418 patients were admitted for orthopaedic and trauma with 84 ...

  5. Editorial: Road safety in Kenya | Otsyeno | East African Orthopaedic ...

    African Journals Online (AJOL)

    East African Orthopaedic Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 2 (2011) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  6. Editorial: Road safety in Kenya | Otsyeno | East African Orthopaedic ...

    African Journals Online (AJOL)

    East African Orthopaedic Journal. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 2 (2011) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Editorial: Road safety in Kenya. F Otsyeno. Abstract. No Abstract. Full Text:.

  7. Management of Patients with Orthopaedic Implants Undergoing Dental Procedures. (United States)

    Quinn, Robert H; Murray, Jayson N; Pezold, Ryan; Sevarino, Kaitlyn S


    The American Academy of Orthopaedic Surgeons, in collaboration with the American Dental Association, has developed Appropriate Use Criteria (AUC) for the Management of Patients with Orthopaedic Implants Undergoing Dental Procedures. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The Management of Patients with Orthopaedic Implants Undergoing Dental Procedures AUC clinical patient scenarios were derived from indications of patients with orthopaedic implants presenting for dental procedures, as well as from current evidence-based clinical practice guidelines and supporting literature to identify the appropriateness of the use of prophylactic antibiotics. The 64 patient scenarios and 1 treatment were developed by the writing panel, a group of clinicians who are specialists in this AUC topic. Next, a separate, multidisciplinary, voting panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as Appropriate (median rating, 7 to 9), May Be Appropriate (median rating, 4 to 6), or Rarely Appropriate (median rating, 1 to 3).

  8. Infections in orthopaedic surgery : clinical and experimental studies

    NARCIS (Netherlands)

    Vogely, Henri Charles


    The diagnostic difficulties, variability in outcome and the heterogeinity of the problem of orthopaedic infections stimulated the author to a study of the literature, and several clinical and experimental studies. The diagnosis prosthesis-related infection can only be reached with an acceptable

  9. Orthopaedic injuries in children: Federal Medical Centre, Umuahia ...

    African Journals Online (AJOL)

    Background: Worldwide, trauma is a recognized leading cause of childhood morbidity, mortality and disability. Aim: To review the causes and consequences of orthopaedic injuries in children. Methods: A retrospective study of all injuries in children 14 years and below seen at the Federal Medical Centre Umuahia from 1st ...

  10. Motives for seeking a second opinion in orthopaedic surgery.

    NARCIS (Netherlands)

    Dalen, I. van; Groothoff, J.; Stewart, R.; Spreeuwenberg, P.; Groenewegen, P.; Horn, J. van


    The number of second opinions in orthopaedic surgery is increading rapidly, yet the grounds on which patients and their doctors decide to seek a second opinion have been little studied. The goal of the study was to identify patient and consultant factors that appeared to contribute to a second

  11. Autologous Bone Grafts Use in Orthopaedic Practice in Abuja ...

    African Journals Online (AJOL)

    Background: There is widespread use of autologous bone grafts in orthopaedic practice in Nigeria but detailed indications, donor sites and complications following use have not been reported in different regions. Objective: This is to highlight the indications, sources and complications of autologous bone grafts use in Abuja, ...

  12. Sites of Autologous Bone Grafts in Orthopaedic Traumatology ...

    African Journals Online (AJOL)

    Background: The use of autologous bone graft in orthopaedic traumatology is not uncommon. But little work, from West African subregion, has been devoted to sites used as sources of autologous bone grafts. Objective: The purpose of this study was to evaluate the evolution of these different sampling sites of autologous ...

  13. Orthopaedic Implants And Prosthesis: Economic Costs Of Post ...

    African Journals Online (AJOL)

    OBJECTIVE: To assess the economic impact of post-operative wound infection in trauma patients who had open reduction and internal fixation with implants and prostheses following fractures of the femur. METHOD: This is a 2-year case controlled prospective study carried out at the National Orthopaedic Hospital, Lagos.

  14. Pattern of Bone Tumours Seen In A Regional Orthopaedic Hospital ...

    African Journals Online (AJOL)

    Background: Primary bone tumour is a challenge to Orthopaedic surgeons working in developing countries due to late presentation as a result of ignorance and poverty. This is further compounded by limited number of specialist personnel, diagnostic and therapeutic centres. Consequently, they are associated with high rate ...

  15. Risk factors for surgical site infections following clean orthopaedic ...

    African Journals Online (AJOL)

    It is recommended that preoperative hospital stay should be as short as possible and extra care/precautions taken when working on the elderly, using implants or requiring drainage. Keywords: Clean orthopaedic operations, risk factors, surgical site infection. Nigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 ...

  16. Discharge against medical advice amongst orthopaedic patients in ...

    African Journals Online (AJOL)

    Background: Discharge Against Medical Advice (DAMA) is a term used when patients opt to leave a hospital against the advice of the doctor. Trauma patients account for a significant percentage of these. This study was aimed at determining the prevalence of and reasons for DAMA amongst Orthopaedic and trauma ...

  17. Burnout Syndrome among Orthopaedic Surgeons in Lagos, Nigeria ...

    African Journals Online (AJOL)

    Background: The burnout syndrome has been associated with decreased job performance and low career satisfaction. There are many studies on surgeon burnout and globally but none has been carried out in Nigeria to address the issue of burnout among orthopaedic surgeons. This study aimed at assessing the

  18. The 25 most cited articles in arthroscopic orthopaedic surgery. (United States)

    Cassar Gheiti, Adrian J; Downey, Richard E; Byrne, Damien P; Molony, Diarmuid C; Mulhall, Kevin J


    The purpose of this study was to use Web of Knowledge to determine which published arthroscopic surgery-related articles have been cited most frequently by other authors by ranking the 25 most cited articles. We furthermore wished to determine whether there is any difference between a categorical "journal-by-journal" analysis and an "all-database" analysis in arthroscopic surgery and whether such a search methodology would alter the results of previously published lists of "citation classics" in the field. We analyzed the characteristics of these articles to determine what qualities make an article important to this subspecialty of orthopaedic surgery. Web of Knowledge was searched on March 7, 2011, using the term "arthroscopy" for citations to articles related to arthroscopy in 61 orthopaedic journals and using the all-database function. Each of the 61 orthopaedic journals was searched separately for arthroscopy-related articles to determine the 25 most cited articles. An all-database search for arthroscopy-related articles was carried out and compared with a journal-by-journal search. Each article was reviewed for basic information including the type of article, authorship, institution, country, publishing journal, and year published. The number of citations ranged from 189 to 567 in a journal-by-journal search and from 214 to 1,869 in an all-database search. The 25 most cited articles on arthroscopic surgery were published in 11 journals: 8 orthopaedic journals and 3 journals from other specialties. The most cited article in arthroscopic orthopaedic surgery was published in The New England Journal of Medicine, which was not previously identified by a journal-by-journal search. An all-database search in Web of Knowledge gives a more in-depth methodology of determining the true citation ranking of articles. Among the top 25 most cited articles, autologous chondrocyte implantation/transplantation is currently the most cited and most popular topic in arthroscopic

  19. Patient Perspectives of Midlevel Providers in Orthopaedic Sports Medicine. (United States)

    Manning, Blaine T; Bohl, Daniel D; Hannon, Charles P; Redondo, Michael L; Christian, David R; Forsythe, Brian; Nho, Shane J; Bach, Bernard R


    Midlevel providers (eg, nurse practitioners and physician assistants) have been integrated into orthopaedic systems of care in response to the increasing demand for musculoskeletal care. Few studies have examined patient perspectives toward midlevel providers in orthopaedic sports medicine. To identify perspectives of orthopaedic sports medicine patients regarding midlevel providers, including optimal scope of practice, reimbursement equity with physicians, and importance of the physician's midlevel provider to patients when initially selecting a physician. Cross-sectional study; Level of evidence, 3. A total of 690 consecutive new patients of 3 orthopaedic sports medicine physicians were prospectively administered an anonymous questionnaire prior to their first visit. Content included patient perspectives regarding midlevel provider importance in physician selection, optimal scope of practice, and reimbursement equity with physicians. Of the 690 consecutive patients who were administered the survey, 605 (87.7%) responded. Of these, 51.9% were men and 48.1% were women, with a mean age of 40.5 ± 15.7 years. More than half (51.2%) perceived no differences in training levels between physician assistants and nurse practitioners. A majority of patients (62.9%) reported that the physician's midlevel provider is an important consideration when choosing a new orthopaedic sports medicine physician. Patients had specific preferences regarding which services should be physician provided. Patients also reported specific preferences regarding those services that could be midlevel provided. There lacked a consensus on reimbursement equity for midlevel practitioners and physicians, despite 71.7% of patients responding that the physician provides a higher-quality consultation. As health care becomes value driven and consumer-centric, understanding patient perspectives on midlevel providers will allow orthopaedic sports medicine physicians to optimize efficiency and patient

  20. Fuzzy C e-I(ec, eo) and Fuzzy Completely C e-I(rc, eo) Functions via Fuzzy e-Open Sets (United States)

    Kamala, K.


    We introduced the notions of fuzzy C e-I(ec, eo) functions and fuzzy completely C e-I(rc, eo) functions via fuzzy e-open sets. Some properties and several characterization of these types of functions are investigated. PMID:27051858

  1. Fuzzy Ce-I(ec,eo) and Fuzzy Completely Ce-I(rc,eo) Functions via Fuzzy e-Open Sets


    Seenivasan, V.; Kamala, K.


    We introduced the notions of fuzzy C e -I(ec, eo) functions and fuzzy completely C e -I(rc, eo) functions via fuzzy e-open sets. Some properties and several characterization of these types of functions are investigated.

  2. Fuzzy Ce-I(ec, eo) and Fuzzy Completely Ce-I(rc, eo) Functions via Fuzzy e-Open Sets. (United States)

    Seenivasan, V; Kamala, K


    We introduced the notions of fuzzy C e-I(ec, eo) functions and fuzzy completely C e-I(rc, eo) functions via fuzzy e-open sets. Some properties and several characterization of these types of functions are investigated.

  3. Does sleep deprivation impair orthopaedic surgeons' cognitive and psychomotor performance? (United States)

    O'Brien, Michael J; O'Toole, Robert V; Newell, Mary Zadnik; Lydecker, Alison D; Nascone, Jason; Sciadini, Marcus; Pollak, Andrew; Turen, Clifford; Eglseder, W Andrew


    Sleep deprivation may slow reaction time, cloud judgment, and impair the ability to think. Our purpose was to study the cognitive and psychomotor performances of orthopaedic trauma surgeons on the basis of the amount of sleep that they obtained. We prospectively studied the performances of thirty-two orthopaedic trauma surgeons (residents, fellows, and attending surgeons) over two four-week periods at an urban academic trauma center. Testing sessions used handheld computers to administer validated cognitive and psychomotor function tests. We conducted a multivariate analysis to examine the independent association between test performance and multiple covariates, including the amount of sleep the night before testing. Our analysis demonstrated that orthopaedic surgeons who had slept four hours or less the night before the test had 1.43 times the odds (95% confidence interval, 1.04 to 1.95; p = 0.03) of committing at least one error on an individual test compared with orthopaedic surgeons who had slept more than four hours the previous night. The Running Memory test, which assesses sustained attention, concentration, and working memory, was most sensitive to deterioration in performance in participants who had had four hours of sleep or less; when controlling for other covariates, the test demonstrated a 72% increase in the odds of making at least one error (odds ratio, 1.72 [95% confidence interval, 1.02 to 2.90]; p = 0.04). No significant decrease in performance with sleep deprivation was shown with the other three tests. Orthopaedic trauma surgeons showed deterioration in performance on a validated cognitive task when they had slept four hours or less the previous night. It is unknown how performance on this test relates to surgical performance.

  4. Orthopaedic podiatry triage: process outcomes of a skill mix initiative. (United States)

    Homeming, Lyndon J; Kuipers, Pim; Nihal, Aneel


    The Orthopaedic Podiatry Triage Clinic (OPodTC) is a 'skill mix' model of care developed in Queensland Health to address the problem of lengthy waiting times for orthopaedic surgery on foot and ankle pathologies. It is based on the recognition that many orthopaedic surgery referrals can be identified early and treated conservatively with podiatry, averting the need for more costly and invasive surgical interventions. The model is collaborative and relies on screening and triage by the podiatrist, rather than delegation by the orthopaedic surgeon. Screening and triage through OPodTC was trialled at three Queensland Health hospital facilities during 2009 and 2010 to improve service timeliness. Patients identified by the OPodTC podiatrist as suitable for conservative management were provided with non-surgical podiatry interventions and discharged if appropriate. Those identified as still requiring surgical intervention after the benefit of interim conservative treatment provided by the podiatrist (or who chose to remain on the list) were returned to their previous place on the orthopaedic waiting list. This paper presents a summary and description of waiting list changes in association with this trial. The OPodTC intervention resulted in a reduction in the non-urgent category of the waiting list across the three hospitals of between 23.3% and 49.7%. Indications from wait-list service data demonstrated increased timeliness and improved patient flow, which are core goals of these skill mix initiatives. This study highlights the potential of screening and triage functions in the skill mix debate. In this example, conservative treatment options were considered first, suitable patients did not have to wait long periods to receive timely and appropriate interventions, and those for whom surgery was indicated, were provided with a more targeted service.

  5. Comparison of GERG-2008 and simpler EoS models in calculation of phase equilibrium and physical properties of natural gas related systems

    DEFF Research Database (Denmark)

    Varzandeh, Farhad; Stenby, Erling Halfdan; Yan, Wei


    Accurate description of thermodynamic properties of natural gas systems is of great significance in the oil and gas industry. For this application, non-cubic equations of state (EoSs) are advantageous due to their better density and compressibility description. Among the non-cubic models, GERG-2008...... is a new wide-range EoS for natural gases and other mixtures of 21 natural gas components. It is considered as a standard reference equation suitable for natural gas applications where highly accurate thermodynamic properties are required. Soave's modification of Benedict-Webb-Rubin (Soave-BWR) Eo......S is another model that despite its empirical nature, provides accurate density description even around the critical point. It is much simpler than GERG-2008 and easier to handle and generalize to reservoir oil fluids. This study presents a comprehensive comparison between GERG-2008 and other cubic (SRK and PR...

  6. Population Health Management: Is There Any Role for Orthopaedics?: An AOA Critical Issues Symposium. (United States)

    Boden, Scott D; Smith, Brian T; Handley, Matthew


    The next phase of health-care reform will accelerate the formation of integrated delivery systems and the creation of value and savings through population health management. Accomplishing this goal requires 3 key factors, including (1) enabling groups of physicians and hospitals to legally work together to cover a broad geographic area, (2) the formation of integrated delivery systems that cover the low to high-acuity and post-acute care spectrums, and (3) identifying mechanisms through which a subspecialty can impact the health of a population of patients.At first glance, it would be easy to assume that this is largely a primary care initiative and that orthopaedic surgeons cannot influence population health since they often just repair things after they have broken or worn out. This symposium will challenge that assumption and demonstrate the potential for orthopaedic surgeons to play a major role in population health management. Some of the mechanisms include implementing shared decision-making for elective procedures, reducing premature/unnecessary imaging and subspecialty referrals, improving bone health (osteoporosis prevention and fall risk assessment), and developing payment methodologies to reward population-based, rather than individual-based, positive musculoskeletal outcomes.

  7. The effect of a non-surgical orthopaedic physician on wait times to see a paediatric orthopaedic surgeon. (United States)

    Bowman, Matthew; Mackey, Anna; Wilson, Nichola; Stott, Ngaire Susan


    High referral volumes to paediatric orthopaedic surgeons create long clinic waiting lists. The use of extended scope roles for doctors and health professionals is one strategy to address these wait times. We completed a 6-month trial of a non-surgical paediatric orthopaedic physician role (NSP) to help manage non-urgent referrals to our service from local general practitioners (GPs). For a 6-month period, the majority of non-urgent GP referrals were assessed by a US-trained NSP. Wait times were compared between this period and the same time period in the previous year. Family and referrer satisfaction was determined through postal surveys. Over the trial period, the NSP saw a total of 155 new patient referrals, which represented 49% of all non-urgent GP referrals for the period. Before the trial, only 75% of non-urgent referrals were seen within 131 days (19 weeks) with 10% waiting more than 215 days (31 weeks). By the end of the trial, 75% of referrals were seen within 55 days (8 weeks) and 90% within 61 days (9 weeks). The most common outcome was discharge with management advice. 12% of patients were referred on to an orthopaedic surgeon but only 1% went on to a surgical wait list. Families and referrers reported high levels of satisfaction and only three patients discharged by the NSP were referred back for orthopaedic surgeon review. The NSP role was effective at reducing clinic wait times for patients with non-urgent paediatric orthopaedic conditions, while maintaining family and referrer satisfaction. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  8. Use of EOS Data in AWIPS for Weather Forecasting (United States)

    Jedlovec, Gary J.; Haines, Stephanie L.; Suggs, Ron J.; Bradshaw, Tom; Darden, Chris; Burks, Jason


    Operational weather forecasting relies heavily on real time data and modeling products for forecast preparation and dissemination of significant weather information to the public. The synthesis of this information (observations and model products) by the meteorologist is facilitated by a decision support system to display and integrate the information in a useful fashion. For the NWS this system is called Advanced Weather Interactive Processing System (AWIPS). Over the last few years NASA has launched a series of new Earth Observation Satellites (EOS) for climate monitoring that include several instruments that provide high-resolution measurements of atmospheric and surface features important for weather forecasting and analysis. The key to the utilization of these unique new measurements by the NWS is the real time integration of the EOS data into the AWIPS system. This is currently being done in the Huntsville and Birmingham NWS Forecast Offices under the NASA Short-term Prediction Research and Transition (SPORT) Program. This paper describes the use of near real time MODIS and AIRS data in AWIPS to improve the detection of clouds, moisture variations, atmospheric stability, and thermal signatures that can lead to significant weather development. The paper and the conference presentation will focus on several examples where MODIS and AIRS data have made a positive impact on forecast accuracy. The results of an assessment of the utility of these products for weather forecast improvement made at the Huntsville NWS Forecast Office will be presented.

  9. MMA-EoS: A Computational Framework for Mineralogical Thermodynamics (United States)

    Chust, T. C.; Steinle-Neumann, G.; Dolejš, D.; Schuberth, B. S. A.; Bunge, H.-P.


    We present a newly developed software framework, MMA-EoS, that evaluates phase equilibria and thermodynamic properties of multicomponent systems by Gibbs energy minimization, with application to mantle petrology. The code is versatile in terms of the equation-of-state and mixing properties and allows for the computation of properties of single phases, solution phases, and multiphase aggregates. Currently, the open program distribution contains equation-of-state formulations widely used, that is, Caloric-Murnaghan, Caloric-Modified-Tait, and Birch-Murnaghan-Mie-Grüneisen-Debye models, with published databases included. Through its modular design and easily scripted database, MMA-EoS can readily be extended with new formulations of equations-of-state and changes or extensions to thermodynamic data sets. We demonstrate the application of the program by reproducing and comparing physical properties of mantle phases and assemblages with previously published work and experimental data, successively increasing complexity, up to computing phase equilibria of six-component compositions. Chemically complex systems allow us to trace the budget of minor chemical components in order to explore whether they lead to the formation of new phases or extend stability fields of existing ones. Self-consistently computed thermophysical properties for a homogeneous mantle and a mechanical mixture of slab lithologies show no discernible differences that require a heterogeneous mantle structure as has been suggested previously. Such examples illustrate how thermodynamics of mantle mineralogy can advance the study of Earth's interior.

  10. Factors Influencing Patient Selection of an Orthopaedic Sports Medicine Physician. (United States)

    Manning, Blaine T; Bohl, Daniel D; Saltzman, Bryan M; Cotter, Eric J; Wang, Kevin C; Epley, Chad T; Verma, Nikhil N; Cole, Brian J; Bach, Bernard R


    The rise in consumer-centric health insurance plans has increased the importance of the patient in choosing a provider. There is a paucity of studies that examine how patients select an orthopaedic sports medicine physician. To evaluate factors that patients consider when choosing an orthopaedic sports medicine physician. Case series; Level of evidence, 4. A total of 1077 patients who sought treatment by 3 sports medicine physicians were administered an anonymous questionnaire. The questionnaire included 19 questions asking respondents to rate the importance of specific factors regarding the selection of orthopaedic sports medicine physicians on a scale of 1 (not important at all) to 10 (very important). The remaining 6 questions were multiple-choice and regarded the following criteria: preferred physician age, appointment availability, clinic waiting room times, travel distance, and medical student/resident involvement. Of the 1077 consecutive patients administered the survey, 382 (35%) responded. Of these, 59% (n = 224) were male, and 41% (n = 158) were female. In ranking the 19 criteria in terms of importance, patients rated board certification (9.12 ± 1.88), being well known for a specific area of expertise (8.27 ± 2.39), and in-network provider status (8.13 ± 2.94) as the 3 most important factors in selecting an orthopaedic sports medicine physician. Radio, television, and Internet advertisements were rated the least important. Regarding physician age, 63% of patients would consider seeking a physician who is ≤65 years old. Approximately 78% of patients would consider seeking a different physician if no appointments were available within 4 weeks. The study results suggest that board certification, being well known for a specific area of expertise, and health insurance in-network providers may be the most important factors influencing patient selection of an orthopaedic sports medicine physician. Advertisements were least important to patients. Patient

  11. Ireland's contribution to orthopaedic literature: a bibliometric analysis. (United States)

    Kennedy, C; O Sullivan, P; Bilal, M; Walsh, A


    Bibliometric analysis of scientific performance within a country or speciality, facilitate the recognition of factors that may further enhance research activity and performance. Our aim was to illicit the current state of Irelands orthopaedic research output in terms of quantity and quality. We performed a retrospective bibliometric analysis of all Irish orthopaedic publications over the past 5 years, in the top 20 peer-reviewed orthopaedic journals. Utilising the MEDLINE database, each journal was evaluated for articles that were published over the study period. Reviews, editorials, reports and letters were excluded. Each article abstract was analysed for research content, and country of origin. A nation's mean IF was defined by multiplying each journal's IF by the number of articles. Publications per million (PmP) was calculated by dividing the total number of publications by the population of each country. We analysed a total of 25,595 article abstracts. Ireland contributed 109 articles in total (0.42% of all articles), however ranking according to population per million was 10th worldwide. Ireland ranked 18th worldwide in relation to mean impact factor, which was 2.91 over the study period. Ireland published in 16 of the top 20 journals, 9 of these were of European origin, and 1 of the top 5 was of American origin. In total, 61 Irish articles were assignable to clinical orthopaedic units. Clinical based studies (randomised controlled trials, observational, and epidemiology/bibliometric articles) and research based studies (In vivo, In vitro, and biomechanical) numbered 76 (69.7%) and 33 (30.2%) articles, respectively. This study provides a novel overview of current Irish orthopaedic related research, and how our standards translate to the worldwide orthopaedic community. In order to maintain our publication productivity, academic research should continue to be encouraged at post graduate level. Copyright © 2013 Royal College of Surgeons of Edinburgh

  12. A European Collaborative EO Summer School for the Education of Undergraduate and Masters Level Students- FORMAT-EO (United States)

    Graves, Rosemarie; Remedios, John; Tramutoli, Valerio; Gil, Artur; Cuca, Branka


    An Erasmus intensive programme has been successfully funded to run a Europe-lead summer school in Earth Observation for the years 2013 and 2014. The summer school, FORMAT-EO (FORmation of Multi-disciplinary Approaches to Training in Earth Observation) has been proposed and implemented by a consortium of eight partner institutions from five European countries. The consortium was facilitated through the NEREUS network. In the summer of 2013, 21 students from seven European institutions took part in the two week intensive course which involved a total of 28 teachers from six institutions. Students were from a variety of backgrounds including aeronautical engineering MSc students and PhD students in the areas of marine biology, earthquake engineering and measurement of trace gases in the atmosphere. The aims of FORMAT-EO were: To give students exposure to the wider applications of Earth Observation To highlight the interdisciplinary, collaborative and international nature of Earth Observation To offer an intensive course to better equip students with specialist skills required for a career in this field To provide expert advice on the development of careers in the EO market Partners were invited not only to recruit students for the course but to also teach at the school based on their specific area of expertise. This approach to the teaching provided a timetable which was wide-ranging and covered topics from EU policies for Earth Observation to fire detection from space and an introduction to interaction between radiation and matter. An important aspect of the course was the interactive nature of much of the teaching. A topic was introduced to the students through a lecture followed by an interactive tutorial providing students with hands-on experience of working with EO data and specialist software. The final days of the summer school were spent on group project work which required students to use all of the skills that they acquired during the course to challenge a

  13. Real-world solutions for orthopaedic on-call problems. (United States)

    Agnew, Samuel G; Blotter, Robert H; Kosmatka, Paul K; Rudin, Guy J


    An increasing percentage of emergency departments are reporting an inadequate number of on-call specialists. This situation is causing a growing crisis in emergency department on-call coverage for patients requiring orthopaedic care. Many orthopaedic surgeons are electing to opt out of emergency department on-call service. For many reasons, including a dwindling supply of eager participants, more medical groups are finding it difficult to fulfill their on-call obligations. This problem demands a variety of strategies to address the multiple causative factors that occur in practice settings. Initially, it may be necessary to incentivize on-call service so more surgeons are willing to participate. Incentives may include improving the group governance and bylaws to avoid confusion on the rules for providing on-call coverage. The on-call experience may require financial improvements, outsourcing with locum tenens, or a complete restructuring of the on-call arrangement with the formation of a hospitalist program.

  14. Bone graft materials in fixation of orthopaedic implants in sheep

    DEFF Research Database (Denmark)

    Babiker, Hassan


    Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many...... orthopaedic procedures, whereas allograft is the gold standard by replacement of extensive bone loss. However, the use of autograft is associated with donor site morbidity, especially chronic pain. In addition, the limited supply is a significant clinical challenge. Limitations in the use of allograft include...... skeletal bones. The osteoconductive properties of the composite might be improved by adding bone marrow aspirate (BMA), which can be harvested during surgery. Other alternatives to bone graft are demineralised bone matrix (DBM) and human cancellous bone (CB). DBM is prepared by acid extraction of human...

  15. A NASA discovery has current applications in orthopaedics. (United States)

    Cotler, Howard B


    Low-level laser therapy (LLLT) has been actively used for nearly 40 yr, during which time it has been known to reduce pain, inflammation, and edema. It also has the ability to promote healing of wounds, including deep tissues and nerves, and prevent tissue damage through cell death. Much of the landmark research was done by the National Aeronautics and Space Administration (NASA), and these studies provided a springboard for many additional basic science studies. Few current clinical studies in orthopaedics have been performed, yet only in the past few years have basic science studies outlined the mechanisms of the effect of LLLT on the cell and subsequently the organism. This article reviews the basic science of LLLT, gives a historical perspective, and explains how it works, exposes the controversies and complications, and shows the new immediately applicable information in orthopaedics.

  16. Organizational Learning in an Orthopaedic Unit: A Learning History. (United States)

    Lyman, Bret; Shaw, Lindsey; Moore, Carly

    The purpose of this study was to explore organizational learning in an orthopaedic hospital unit. Skill in organizational learning is necessary to achieve high reliability in a dynamic healthcare environment, yet organizational learning in hospital units is not well understood. A learning history was conducted with a high-performing orthopaedic unit. Findings were interpreted in the context of a previous learning history conducted with a critical care unit. Despite contextual differences, each unit progressed through the same four developmental stages to achieve its current state of high reliability. On both units, psychological safety and a healthy work environment proved essential for developmental progression. Hospital units may progress through distinct developmental stages to achieve their desired outcomes. Psychological safety and a healthy work environment appear foundational to organizational learning in hospital units. Nursing leaders should work with team members to evaluate their unit's development and use suggested strategies to facilitate organizational learning.

  17. Mission operations update for the restructured Earth Observing System (EOS) mission (United States)

    Kelly, Angelita Castro; Chang, Edward S.


    The National Aeronautics and Space Administration's (NASA) Earth Observing System (EOS) will provide a comprehensive long term set of observations of the Earth to the Earth science research community. The data will aid in determining global changes caused both naturally and through human interaction. Understanding man's impact on the global environment will allow sound policy decisions to be made to protect our future. EOS is a major component of the Mission to Planet Earth program, which is NASA's contribution to the U.S. Global Change Research Program. EOS consists of numerous instruments on multiple spacecraft and a distributed ground system. The EOS Data and Information System (EOSDIS) is the major ground system developed to support EOS. The EOSDIS will provide EOS spacecraft command and control, data processing, product generation, and data archival and distribution services for EOS spacecraft. Data from EOS instruments on other Earth science missions (e.g., Tropical Rainfall Measuring Mission (TRMM)) will also be processed, distributed, and archived in EOSDIS. The U.S. and various International Partners (IP) (e.g., the European Space Agency (ESA), the Ministry of International Trade and Industry (MITI) of Japan, and the Canadian Space Agency (CSA)) participate in and contribute to the international EOS program. The EOSDIS will also archive processed data from other designated NASA Earth science missions (e.g., UARS) that are under the broad umbrella of Mission to Planet Earth.

  18. Assessing heat fluxes and water quality trends in subalpine lakes from EO (United States)

    Cazzaniga, Ilaria; Giardino, Claudia; Bresciani, Mariano; Elli, Chiara; Valerio, Giulia; Pilotti, Marco


    Lakes play a fundamental role in providing ecosystem services such as water supplying, hydrological regulation, climate change mitigation, touristic recreation (Schallenberg et al., 2013). Preserving and improving of quality of lakes waters, which is a function of either both natural and human influences, is therefore an important action to be considered. Remote Sensing techniques are spreading as useful instrument for lakes, by integrating classical in situ limnological measurements to frequent and synoptic monitoring capabilities. Within this study, Earth Observation data are exploited for understanding the temporal changes of water quality parameters over a decade, as well as for measuring the surface energy fluxes in recent years in deep clear lakes in the European subalpine ecoregion. According to Pareth et al. (2016), subalpine lakes are showing a clear response to climate change with an increase of 0.017 °C /year of lake surface temperature, whilst the human activities contribute to produce a large impact (agriculture, recreation, industry, fishing and drinking) on these lakes. The investigation is focused on Lake Iseo, which has shown a significant deterioration of water quality conditions since the seventies, and on Lake Garda, the largest Italian lake where EO data have been widely used for many purposes and applications (Giardino et al., 2014). Available ENVISAT-MERIS (2002-2012) and Landsat-8-OLI (2013-on going) imagery has been exploited to produce chlorophyll-a (chl-a) concentration maps, while Landsat-8-TIRS imagery has been used for estimating lake surface temperatures. MERIS images were processed through a neural network (namely the C2R processor, Doerffer et al., 2007), to correct the atmospheric effects and to retrieve water constituents concentration in optically complex deep waters. With regard to L8's images, some atmospheric correctors (e.g. ACOLITE and 6SV) were tested and validated to indentify, for each of the two lakes, the more accurate

  19. Vancouver winters: Environmental influences on inpatient adult orthopaedic trauma demographics

    International Nuclear Information System (INIS)

    Noordin, S.; Masri, B. A.


    Objective: To compare the pattern of adult inpatient orthopaedic injuries admitted at three Vancouver hospitals following one of the worst winter snowstorms in the region with the preceding control winter period. Methods: The surveillance study was conducted at the University of British Columbia, Vancouver, Canada, 2007 to 2010. Inpatient adult admissions for orthopaedic injuries at three hospitals were recorded, including age, gender, anatomic location of injury, type of fracture (open or closed), fixation method (internal versus external fixation), and length of acute care hospital stay. Comparisons between admissions during this weather pattern and admission during a previous winter with minimal snow were made. SPSS 19 was used for statistical analysis. Results: Of the 511 patients admitted under Orthopaedic trauma service during the significant winter snowstorms of December 2008 - January 2009, 100 (19.6%) (CI: 16.2%-23.2%) were due to ice and snow, whereas in the preceding mild winter only 18 of 415 (4.3%) (CI: 2.5%-6.8%) cases were related to snow (p<0.05). Ankle and wrist fractures were the most frequent injuries during the index snow storm period (p<0.05). At all the three institutions, 97 (96.5%) fractures were closed during the snowstorm as opposed to 17 (95%) during the control winter period. Internal fixation in 06 (89%) fractures as opposed to external fixation in 12 (11%) patients was the predominant mode of fixation across the board during both time periods. Conclusion: The study demonstrated a significantly higher inpatient orthopaedic trauma volume during the snowstorm more rigorous prospective studies need to be designed to gain further insight to solving these problems from a public health perspective. (author)

  20. Biocompatibility of orthopaedic implants on bone forming cells


    Kapanen, A. (Anita)


    Abstract Reindeer antler was studied for its possible use as a bone implant material. A molecular biological study showed that antler contains a growth factor promoting bone formation. Ectopic bone formation assay showed that antler is not an equally effective inducer as allogenic material. Ectopic bone formation assay was optimised for biocompatibility studies of orthopaedic NiTi implants. Ti-6Al-4V and stainless steel were used as reference materials. The assay...

  1. Effectiveness of Virtual Reality Training in Orthopaedic Surgery. (United States)

    Aïm, Florence; Lonjon, Guillaume; Hannouche, Didier; Nizard, Rémy


    The purpose of this study was to conduct a systematic review to determine the effectiveness of virtual reality (VR) training in orthopaedic surgery. A comprehensive systematic review was performed of articles of VR training in orthopaedic surgery published up to November 2014 from MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases. We included 10 relevant trials of 91 identified articles, which all reported on training in arthroscopic surgery (shoulder, n = 5; knee, n = 4; undefined, n = 1). A total of 303 participants were involved. Assessment after training was made on a simulator in 9 of the 10 studies, and in one study it took place in the operating room (OR) on a real patient. A total of 32 different outcomes were extracted; 29 of them were about skills assessment. None involved a patient-related outcome. One study focused on anatomic learning, and the other evaluated technical task performance before and after training on a VR simulator. Five studies established construct validity. Three studies reported a statistically significant improvement in technical skills after training on a VR simulator. VR training leads to an improvement of technical skills in orthopaedic surgery. Before its widespread use, additional trials are needed to clarify the transfer of VR training to the OR. Systematic review of Level I through Level IV studies. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  2. Regenerative orthopaedics: in vitro, in silico. (United States)

    Geris, Liesbet


    In silico, defined in analogy to in vitro and in vivo as those studies that are performed on a computer, is an essential step in problem-solving and product development in classical engineering fields. The use of in silico models is now slowly easing its way into medicine. In silico models are already used in orthopaedics for the planning of complicated surgeries, personalised implant design and the analysis of gait measurements. However, these in silico models often lack the simulation of the response of the biological system over time. In silico models focusing on the response of the biological systems are in full development. This review starts with an introduction into in silico models of orthopaedic processes. Special attention is paid to the classification of models according to their spatiotemporal scale (gene/protein to population) and the information they were built on (data vs hypotheses). Subsequently, the review focuses on the in silico models used in regenerative orthopaedics research. Contributions of in silico models to an enhanced understanding and optimisation of four key elements-cells, carriers, culture and clinics-are illustrated. Finally, a number of challenges are identified, related to the computational aspects but also to the integration of in silico tools into clinical practice.

  3. Neoprene Orthopaedic Supports: An Underrecognised Cause of Allergic Contact Dermatitis

    Directory of Open Access Journals (Sweden)

    S. Hawkey


    Full Text Available Thioureas, often contained within neoprene to provide water resistance, are an important cause of allergic contact dermatitis (ACD in those who use neoprene products. We wish to present three cases of thiourea-induced ACD from three different orthopaedic supports containing neoprene. The first case was a 67-year-old woman who developed an itchy rash on her heel three weeks after using a neoprene insole for plantar fasciitis. The second case was a 47-year-old man who developed an itchy rash on his wrist after wearing neoprene wrist splints for psoriatic arthropathy. The third case was a 77-year-old woman who experienced a severe erythematous rash with blistering from a neoprene elbow brace she received following a humeral fracture. All patients were patch tested to the British Society of Cutaneous Allergy Standard and rubber series and a cut piece from all the relevant supports. At 96 hours, all patients had a + reaction to mixed dialkylthiourea, diethylthiourea, and the supports’ material. No other positive patch test reactions were identified. As neoprene is fast becoming one of the most popular materials used for orthopaedic supports, awareness of this reaction and close liaison between dermatologists and orthopaedic surgeons are therefore essential to allow for early recognition of this complication.

  4. Factors driving physician-hospital alignment in orthopaedic surgery. (United States)

    Page, Alexandra E; Butler, Craig A; Bozic, Kevin J


    The relationships between physicians and hospitals are viewed as central to the proposition of delivering high-quality health care at a sustainable cost. Over the last two decades, major changes in the scope, breadth, and complexities of these relationships have emerged. Despite understanding the need for physician-hospital alignment, identification and understanding the incentives and drivers of alignment prove challenging. Our review identifies the primary drivers of physician alignment with hospitals from both the physician and hospital perspectives. Further, we assess the drivers more specific to motivating orthopaedic surgeons to align with hospitals. We performed a comprehensive literature review from 1992 to March 2012 to evaluate published studies and opinions on the issues surrounding physician-hospital alignment. Literature searches were performed in both MEDLINE(®) and Health Business™ Elite. Available literature identifies economic and regulatory shifts in health care and cultural factors as primary drivers of physician-hospital alignment. Specific to orthopaedics, factors driving alignment include the profitability of orthopaedic service lines, the expense of implants, and issues surrounding ambulatory surgery centers and other ancillary services. Evolving healthcare delivery and payment reforms promote increased collaboration between physicians and hospitals. While economic incentives and increasing regulatory demands provide the strongest drivers, cultural changes including physician leadership and changing expectations of work-life balance must be considered when pursuing successful alignment models. Physicians and hospitals view each other as critical to achieving lower-cost, higher-quality health care.

  5. SCAR-B fires in the tropics: Properties and remote sensing from EOS-MODIS (United States)

    Kaufman, Yoram J.; Kleidman, Richard G.; King, Michael D.


    Two moderate resolution imaging spectroradiometer (MODIS) instruments are planned for launch in 1999 and 2000 on the NASA Earth Observing System (EOS) AM-1 and EOS PM-1 satellites. The MODIS instrument will sense fires with designated 3.9 and 11 μm channels that saturate at high temperatures (450 and 400 K, respectively). MODIS data will be used to detect fires, to estimate the rate of emission of radiative energy from the fire, and to estimate the fraction of biomass burned in the smoldering phase. The rate of emission of radiative energy is a measure of the rate of combustion of biomass in the fires. In the Smoke, Clouds, and Radiation-Brazil (SCAR-B) experiment the NASA ER-2 aircraft flew the MODIS airborne simulator (MAS) to measure the fire thermal and mid-IR signature with a 50 m spatial resolution. These data are used to observe the thermal properties and sizes of fires in the cerrado grassland and Amazon forests of Brazil and to simulate the performance of the MODIS 1 km resolution fire observations. Although some fires saturated the MAS 3.9 μm channel, all the fires were well within the MODIS instrument saturation levels. Analysis of MAS data over different ecosystems, shows that the fire size varied from single MAS pixels (50×50 m) to over 1 km2. The 1×1 km resolution MODIS instrument can observe only 30-40% of these fires, but the observed fires are responsible for 80 to nearly 100% of the emitted radiative energy and therefore for 80 to 100% of the rate of biomass burning in the region. The rate of emission of radiative energy from the fires correlated very well with the formation of fire burn scars (correlation coefficient = 0.97). This new remotely sensed quantity should be useful in regional estimates of biomass consumption.

  6. The Impact of Prior Upper Extremity Surgery on Orthopaedic Injury and Surgery in Collegiate Athletes (United States)

    Rugg, Caitlin Marie; Wang, Dean; Mayer, Erik; Berger, Neal; Vail, Jeremy; Sulzicki, Pamela; Hame, Sharon L.


    Objectives: Upper extremity injuries are common in youth, collegiate, and professional athletics, and may require operative management. The influence of a prior upper extremity surgery on subsequent athletic participation, injury, and surgery in college is not well understood. The purpose of this study was to investigate the impact of prior upper extremity surgery in Division I collegiate athletes on participation, injury rates, and surgery rates in college. Methods: Division I athletes who began participation in collegiate athletics from 2003 - 2009 were retrospectively identified. These athletes represented 21 sports teams at a single institution. Athletes with prior upper extremity orthopaedic surgery, including shoulder, elbow, and wrist/hand surgery, were identified through preparticipation evaluation forms. Sport, seasons played, injuries sustained during college, days missed, and college orthopaedic surgeries and diagnostic imaging were collected through sports archives, medical records, and the Sports Injury Monitoring System (SIMS) and compared to athletes with no prior history of upper extremity surgery. Subgroup analysis was performed for athletes with a history of shoulder, elbow, and wrist/hand surgeries. Results: Between 2003 and 2009, 1,145 athletes completed pre-participation evaluation forms. In total, 77 athletes (6.7%) had a history of one or more upper extremity surgeries prior to collegiate athletics. History of upper extremity surgery was most common in incoming men's water polo (15.0%), baseball (14.9%), and football (12.6%) athletes. Athletes with a prior upper extremity surgery had a higher rate of upper extremity injury in college compared to controls (Hazard Ratio = 4.127, p Athletes with a prior shoulder surgery (n=20) also had a higher rate of upper extremity injury in college compared to controls (Hazard Ratio= 15,083, p=0.02). They missed more total athletic days per season (77.5 days vs. 29.8 days, p athletes with a history of upper

  7. Assessing the Agreement Between Eo-Based Semi-Automated Landslide Maps with Fuzzy Manual Landslide Delineation (United States)

    Albrecht, F.; Hölbling, D.; Friedl, B.


    Landslide mapping benefits from the ever increasing availability of Earth Observation (EO) data resulting from programmes like the Copernicus Sentinel missions and improved infrastructure for data access. However, there arises the need for improved automated landslide information extraction processes from EO data while the dominant method is still manual delineation. Object-based image analysis (OBIA) provides the means for the fast and efficient extraction of landslide information. To prove its quality, automated results are often compared to manually delineated landslide maps. Although there is awareness of the uncertainties inherent in manual delineations, there is a lack of understanding how they affect the levels of agreement in a direct comparison of OBIA-derived landslide maps and manually derived landslide maps. In order to provide an improved reference, we present a fuzzy approach for the manual delineation of landslides on optical satellite images, thereby making the inherent uncertainties of the delineation explicit. The fuzzy manual delineation and the OBIA classification are compared by accuracy metrics accepted in the remote sensing community. We have tested this approach for high resolution (HR) satellite images of three large landslides in Austria and Italy. We were able to show that the deviation of the OBIA result from the manual delineation can mainly be attributed to the uncertainty inherent in the manual delineation process, a relevant issue for the design of validation processes for OBIA-derived landslide maps.


    Directory of Open Access Journals (Sweden)

    F. Albrecht


    Full Text Available Landslide mapping benefits from the ever increasing availability of Earth Observation (EO data resulting from programmes like the Copernicus Sentinel missions and improved infrastructure for data access. However, there arises the need for improved automated landslide information extraction processes from EO data while the dominant method is still manual delineation. Object-based image analysis (OBIA provides the means for the fast and efficient extraction of landslide information. To prove its quality, automated results are often compared to manually delineated landslide maps. Although there is awareness of the uncertainties inherent in manual delineations, there is a lack of understanding how they affect the levels of agreement in a direct comparison of OBIA-derived landslide maps and manually derived landslide maps. In order to provide an improved reference, we present a fuzzy approach for the manual delineation of landslides on optical satellite images, thereby making the inherent uncertainties of the delineation explicit. The fuzzy manual delineation and the OBIA classification are compared by accuracy metrics accepted in the remote sensing community. We have tested this approach for high resolution (HR satellite images of three large landslides in Austria and Italy. We were able to show that the deviation of the OBIA result from the manual delineation can mainly be attributed to the uncertainty inherent in the manual delineation process, a relevant issue for the design of validation processes for OBIA-derived landslide maps.

  9. Philosophy and Architecture of the EOS Data and Information System (United States)

    Maiden, Martha

    In 2009, NASA's EOS Data and Information System (EOSDIS) is the world's largest distributed data and information system infrastructure principally supporting science, a coupled, complex network of production capabilities and data systems. Data and information are easily available through the World Wide Web from searchable, on-line data stores with sophisticated metadata schema, data dictionaries, and comprehensive scientific and technical documentation of its holdings. NASA is moving towards adoption of a service-oriented approach deploying Web services, which enable users to make connections between distributed and heterogeneous elements of environmental data and services internal to and external from EOSDIS as needed. Pertinent Web services are accessible via EOSDIS. Examples of data services include subsetting, data reformatting, and search services such as a thesaurus. The principal subject matter of this book, the MODIS and ASTER instruments, and their derived data, products and applications owe their existence and success to EOSDIS.

  10. GDAL Enhancements for Interoperability with EOS Data (GEE) (United States)

    Tisdale, B.


    Historically, Earth Observing Satellite (EOS) data products have been difficult to consume by GIS tools, weather commercial or open-source. This has resulted in a reduced acceptance of these data products by GIS and general user communities. Common problems and challenges experienced by these data users include difficulty when: Consuming data products from NASA Distributed Active Archive Centers (DAACs) that pre-date modern application software with commercial and open-source geospatial tools; Identifying[MI1] an initial approach for developing a framework and plug-ins that interpret non-compliant data; Defining a methodology that is extensible across NASA Earth Observing System Data and Information System (EOSDIS), scientific communities, and GIS communities by enabling other data centers to construct their own plug-ins and adjust specific data products; and Promoting greater use of NASA Data and new analysis utilizing GIS tools. To address these challenges and make EOS data products more accessible and interpretable by GIS applications, a collaborative approach has been taken that includes the NASA Langley Atmospheric Science Data Center (ASDC), Esri, George Mason University (GMU), and the Hierarchical Data Format (HDF) Group to create a framework and plugins to be applied to Geospatial Data Abstraction Library (GDAL). This framework and its plugins offer advantages of extensibility within NASA EOSDIS, permitting other data centers to construct their own plugins necessary to adjust their data products. In this session findings related to the framework and the development of GDAL plugins will be reviewed. Specifically, this session will offer a workshop to review documentation and training materials that have been generated for the purpose of guiding other NASA DAACs through the process of constructing plug-ins consistent with the framework as well as a review of the certification process by which the plugins can be independently verified as properly converting

  11. An Observation Capability Metadata Model for EO Sensor Discovery in Sensor Web Enablement Environments

    Directory of Open Access Journals (Sweden)

    Chuli Hu


    Full Text Available Accurate and fine-grained discovery by diverse Earth observation (EO sensors ensures a comprehensive response to collaborative observation-required emergency tasks. This discovery remains a challenge in an EO sensor web environment. In this study, we propose an EO sensor observation capability metadata model that reuses and extends the existing sensor observation-related metadata standards to enable the accurate and fine-grained discovery of EO sensors. The proposed model is composed of five sub-modules, namely, ObservationBreadth, ObservationDepth, ObservationFrequency, ObservationQuality and ObservationData. The model is applied to different types of EO sensors and is formalized by the Open Geospatial Consortium Sensor Model Language 1.0. The GeosensorQuery prototype retrieves the qualified EO sensors based on the provided geo-event. An actual application to flood emergency observation in the Yangtze River Basin in China is conducted, and the results indicate that sensor inquiry can accurately achieve fine-grained discovery of qualified EO sensors and obtain enriched observation capability information. In summary, the proposed model enables an efficient encoding system that ensures minimum unification to represent the observation capabilities of EO sensors. The model functions as a foundation for the efficient discovery of EO sensors. In addition, the definition and development of this proposed EO sensor observation capability metadata model is a helpful step in extending the Sensor Model Language (SensorML 2.0 Profile for the description of the observation capabilities of EO sensors.

  12. Reshaping orthopaedic resident education in systems-based practice. (United States)

    Roberts, Susanne M; Jarvis-Selinger, Sandra; Pratt, Daniel D; Polonijo, Andrea; Polinijo, Andrea; Stacy, Elizabeth; Wisener, Katherine; Black, Kevin P


    Despite advances in understanding the "systems-based practice" competency in resident education, this topic has remained difficult to teach, assess, and document. The goal of this study was to perform a needs assessment and an analysis of the current state of systems-based practice education in orthopaedic residency programs across the U.S. and within our own institution. A sample of orthopaedic educators and residents from across the U.S. who were attending the 2010 American Orthopaedic Association (AOA) Effective Orthopaedic Educator Course, AOA Resident Leadership Forum, and AOA Council of Residency Directors meeting were surveyed to determine (1) which aspects of systems-based practice, if any, were being taught; (2) how systems-based practice is being taught; and (3) how residency programs are assessing systems-based practice. In addition, an in-depth case study of these issues was performed by means of seven semi-structured focus group sessions with diverse stakeholders who participated in the care of musculoskeletal patients at the authors' institution. A quantitative approach was used to analyze the survey data. The focus group data were analyzed with procedures associated with grounded theory, relying on a constant comparative method to develop salient themes arising from the discussion. "Clinical observation" (33%) and "didactic case-based learning" (23%) were reported by the survey respondents as the most commonly used teaching methods, but specific topics were taught inconsistently. Competency assessment was reported to occur infrequently, and 36% of respondents reported that systems-based practice areas were not being assessed by any methods. The focus group discussions emphasized the need for standardized experiential learning that was closely linked to the patient's perspective. Orthopaedic faculty members were uncomfortable with their knowledge of this competency and their ability to teach and assess it. Teaching the systems-based practice

  13. 7 CFR 1962.34 - Transfer of chattel security and EO property and assumption of debts. (United States)


    ... SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) PERSONAL PROPERTY Servicing and Liquidation of Chattel Security § 1962.34 Transfer of chattel security and EO property and... 7 Agriculture 14 2010-01-01 2009-01-01 true Transfer of chattel security and EO property and...

  14. 7 CFR 1962.41 - Sale of chattel security or EO property by borrowers. (United States)


    ..., DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) PERSONAL PROPERTY Servicing and Liquidation of Chattel Security § 1962.41 Sale of chattel security or EO property by borrowers. Borrowers who... 7 Agriculture 14 2010-01-01 2009-01-01 true Sale of chattel security or EO property by borrowers...

  15. The efficacy of an extended scope physiotherapy clinic in paediatric orthopaedics.

    LENUS (Irish Health Repository)

    O Mir, Marie


    The demand for paediatric orthopaedic care is growing, and providing the service required is an increasingly challenging task. Physiotherapist-led triage clinics are utilised in adult orthopaedics to enable the provision of care to patients who may not require a surgical consult. The Physiotherapy Orthopaedic Triage Clinic (POTC) was established in Our Lady\\'s Children\\'s Hospital Crumlin in response to increasing demands on the paediatric orthopaedic service. The clinic is run by physiotherapists working in an advanced practice role (APP), and is the first paediatric clinic of its type and scale in the Republic of Ireland.

  16. EO Domain Specific Knowledge Enabled Services (KES-B) (United States)

    Varas, J.; Busto, J.; Torguet, R.


    This paper recovers and describes a number of major statements with respect to the vision, mission and technological approaches of the Technological Research Project (TRP) "EO Domain Specific Knowledge Enabled Services" (project acronym KES-B), which is currently under development at the European Space Research Institute (ESRIN) under contract "16397/02/I- SB". Resulting from the on-going R&D activities, the KES-B project aims are to demonstrate with a prototype system the feasibility of the application of innovative knowledge-based technologies to provide services for easy, scheduled and controlled exploitation of EO resources (e.g.: data, algorithms, procedures, storage, processors, ...), to automate the generation of products, and to support users in easily identifying and accessing the required information or products by using their own vocabulary, domain knowledge and preferences. The ultimate goals of KES-B are summarized in the provision of the two main types of KES services: 1st the Search service (also referred to as Product Exploitation or Information Retrieval; and 2nd the Production service (also referred to as Information Extraction), with the strategic advantage that they are enabled by Knowledge consolidated (formalized) within the system. The KES-B system technical solution approach is driven by a strong commitment for the adoption of industry (XML-based) language standards, aiming to have an interoperable, scalable and flexible operational prototype. In that sense, the Search KES services builds on the basis of the adoption of consolidated and/or emergent W3C semantic-web standards. Remarkably the languages/models Dublin Core (DC), Universal Resource Identifier (URI), Resource Description Framework (RDF) and Ontology Web Language (OWL), and COTS like Protege [1] and JENA [2] are being integrated in the system as building bricks for the construction of the KES based Search services. On the other hand, the Production KES services builds on top of

  17. EosFit-Pinc: a GUI program to calculate pressures in host-inclusion systems (United States)

    Angel, Ross; Alvaro, Matteo; Mazzucchelli, Mattia; Nestola, Fabrizio


    A remnant pressure in an inclusion trapped inside a host mineral is developed because the inclusion and the host have different thermal expansion and compressibilities, and the inclusion does not expand in response to P and T as would a free crystal. Instead it is restricted to expand only as much as the cavity of the host mineral, and this constriction in volume can result in inclusions exhibiting over-pressures when the host is studied at room conditions. The remnant pressure of the inclusion, measured by X-ray diffractometry, birefringence analysis or Raman spectroscopy, can then be used with the equations of state (EoS) of the host and inclusion to constrain the P and T at entrapment. This concept has been known for a long time, but satisfactory quantitative modelling of inclusion-host systems based on non-linear elasticity theory and precise EoS has only recently come available (Angel et al., 2014, 2015), even though calculations still assume isotropic elastic properties. The elasticity calculations to determine entrapment conditions involving the EoSs for both the host and the inclusion are complex if thermodynamically-realistic EoS are employed. We have therefore developed a simple GUI program, EosFit-Pinc that performs all of the necessary calculations under the assumptions of isotropic elasticity. Equations of state of the host and the inclusion can be loaded as files created by other software in the EosFit7 program suite, or imported directly from thermodynamic databases such as Thermocalc. The complete range of EoS types supported by EosFit-7 are available in EosFit-Pinc. Fluid EoS can be provided in the form of PVT tables, which allows fluid inclusions to be modelled. Once loaded, the EoS of the host and inclusion can be used to calculate the entrapment isomeke from the measured remnant pressure of the inclusion. Or the final pressure can be calculated if the entrapment conditions are known or estimated. Calculations of the isochors of both the host and

  18. Quantification of facial contamination with blood during orthopaedic procedures.

    LENUS (Irish Health Repository)

    Collins, D


    Operative surgery exposes the surgeon to possible blood-borne infections. Risks include pen-etrating injuries and conjunctival contact with infected blood. Visor masks worn during orthopaedic trauma procedures were assessed for blood contamination using computer analysis. This was found to be present on 86% of masks, of which only 15% was recognized by the surgeon intraoperatively. Of the blood splashes 80% were less than 0.6mm in diameter. We conclude that power instrumentation produces a blood particulate mist causing considerable microscopic, facial contamination which is a significant risk to the surgeon.

  19. Conductive polymer sensor arrays for smart orthopaedic implants (United States)

    Micolini, Carolina; Holness, F. B.; Johnson, James A.; Price, Aaron D.


    This study proposes and demonstrates the design, implementation, and characterization of a 3D-printed smartpolymer sensor array using conductive polyaniline (PANI) structures embedded in a polymeric substrate. The piezoresistive characteristics of PANI were studied to evaluate the efficacy of the manufacturing of an embedded pressure sensor. PANI's stability throughout loading and unloading cycles together with the response to incremental loading cycles was investigated. It is demonstrated that this specially developed multi-material additive manufacturing process for polyaniline is a good candidate for the manufacture of implant components with smart-polymer sensors embedded for the analysis of joint loads in orthopaedic implants.

  20. Eos Interviews Robert Van Hook, Former AGU Interim Executive Director (United States)

    Showstack, Randy


    Robert Van Hook, who served as AGU's interim executive director since January 2009, led the organization during a transition period that began with the retirement of long-serving executive director A. F. (“Fred”) Spilhaus Jr. Van Hook's tenure concluded on 30 August when Christine McEntee assumed her position as AGU's new executive director (see Eos, 91(17), 153, 156, 2010). During his tenure at AGU, which overlapped with a global economic recession, Van Hook helped to guide the organization through key structural governance changes, strategic planning, and upgrades in technology, human resources, and accounting. He also helped to revitalize public outreach and member services, among many other efforts. Van Hook, president of Transition Management Consulting, recently reflected upon his tenure, the transition period, and the future of AGU. Van Hook credits AGU's strong volunteer leadership—including past presidents Tim Killeen and Tim Grove, current president Mike McPhaden, and president-elect Carol Finn—for courage in moving the organization through a successful transition. “They were the ones who shoved the boat off from the shore. I was lucky enough to be invited into the boat,” he said. He also credits the staff for their resiliency and commitment to supporting AGU's science.

  1. Eos negatively regulates human γ-globin gene transcription during erythroid differentiation.

    Directory of Open Access Journals (Sweden)

    Hai-Chuan Yu

    Full Text Available BACKGROUND: Human globin gene expression is precisely regulated by a complicated network of transcription factors and chromatin modifying activities during development and erythropoiesis. Eos (Ikaros family zinc finger 4, IKZF4, a member of the zinc finger transcription factor Ikaros family, plays a pivotal role as a repressor of gene expression. The aim of this study was to examine the role of Eos in globin gene regulation. METHODOLOGY/PRINCIPAL FINDINGS: Western blot and quantitative real-time PCR detected a gradual decrease in Eos expression during erythroid differentiation of hemin-induced K562 cells and Epo-induced CD34+ hematopoietic stem/progenitor cells (HPCs. DNA transfection and lentivirus-mediated gene transfer demonstrated that the enforced expression of Eos significantly represses the expression of γ-globin, but not other globin genes, in K562 cells and CD34+ HPCs. Consistent with a direct role of Eos in globin gene regulation, chromatin immunoprecipitaion and dual-luciferase reporter assays identified three discrete sites located in the DNase I hypersensitivity site 3 (HS3 of the β-globin locus control region (LCR, the promoter regions of the Gγ- and Aγ- globin genes, as functional binding sites of Eos protein. A chromosome conformation capture (3C assay indicated that Eos may repress the interaction between the LCR and the γ-globin gene promoter. In addition, erythroid differentiation was inhibited by enforced expression of Eos in K562 cells and CD34+ HPCs. CONCLUSIONS/SIGNIFICANCE: Our results demonstrate that Eos plays an important role in the transcriptional regulation of the γ-globin gene during erythroid differentiation.

  2. La salle de cinéma comme attraction spectacle : le cas Captain Eo à Disneyland Paris The Movie theater as attraction: The Case of Captain Eo at Disneyland Paris

    Directory of Open Access Journals (Sweden)

    Jean-Baptiste Massuet


    Full Text Available Cet article a pour ambition d’interroger le rapport du public à une salle de cinéma précise, au cœur du parc Disneyland Paris à Marne-La-Vallée. Cette salle projette à nouveau depuis juin 2010 l’attraction Captain Eo, film de science-fiction en 3D relief réalisé par Francis Ford Coppola en 1986, avec Michael Jackson dans le rôle-titre. Remplacé depuis 1998 par une autre attraction, Captain Eo fait son retour un an après le décès de la star, et implique dès lors un rapport très particulier à son public, par son statut d’hommage post-mortem. Il s’agira de comprendre la façon dont l’attraction structure son public, et la façon dont celui-ci peut construire à son tour le sens du film qu’il est en train de voir. C’est donc une approche sémio-pragmatique que nous convoquons ici, en nous référant à Roger Odin, afin d’envisager, à partir du film lui-même et de son mode de diffusion, ce que l’attraction Captain Eo révèle théoriquement du lien entre le spectateur et l’image d’une star comme Michael Jackson, qui plus est un an après son décès. Il s’agira de comprendre de quelle manière le film de Coppola ainsi que son contexte de diffusion – le parc d’attraction Disneyland Paris – permettent de penser ou d’interroger un type de pratique spectatorielle différent de celles engendrées par d'autres salles de cinéma.This article tries to question the link between the public and a precise movie theater, in Disneyland Paris Marne-La-Vallée, proposing again since june 2010 the attraction Captain Eo, science-fiction 3D movie by Francis Ford Coppola in 1986, starring Michael Jackson. Replaced since 1998 by another attraction, Captain Eo comes back one year after the death of the star, and implies un specific link with its public, being a post-mortem tribute. We have to understand the way the attraction builds its public, and the way this one can build the movie signification in return. We have

  3. Demographics, nature and treatment of orthopaedic trauma injuries occurring in an agricultural context in the West of Ireland.

    LENUS (Irish Health Repository)

    Byrne, F J


    Farming is a major industry in the West of Ireland. This prospective study examined the age profile, nature and treatment of orthopaedic injuries occurring in agricultural surroundings presenting at the Orthopaedic Unit of Merlin Park Hospital, Galway.

  4. Antoni marian gabryszewski as a pioneer of orthopaedics and rehabilitation in poland. (United States)

    Jandziś, Sławomir


    This article describes the work of Dr. Antoni Marian Gabryszewski, orthopaedic surgeon, associate professor at Lvov University, towards the development of orthopaedics and rehabilitation in Poland before World War I. It is based on archival materials, publications in medical journals and articles from the daily press of that time. The author presents little-known facts concerning Dr. Gabryszewski's occupational and academic activity and his work at the Surgery Dept. of Lvov University as well as his habilitation dissertation, regarded as the first attempt to position orthopaedics as distinct from surgery in Poland. The article also describes his long-term work at the private Orthopaedic Facility established in 1898 in Lvov which later incorporated the Zander Institute in 1908. The Zander Institute was the first in Galicia to offer exercise machines designed by Dr. Gustav Zander, imported from Stockholm and enjoying an extraordinary popularity in the world. Dr. Gabryszewski's practice as a spa doctor, which he pursued in Iwonicz Zdrój in the summer months, is also presented. Dr. A. Gabryszewski introduced comprehensive rehabilitation to the treatment of orthopaedic patients both at the Surgery Dept. of Lvov University and at his Orthopaedic Facility. He used therapeutic gymnastics (particularly mechanotherapy), therapeutic massage, physical therapy and orthopaedic aids. Analysis of the source materials leads to unequivocal conclusions attesting to Dr. A. Gabryszewski's pioneering role and significant contribution to the development of orthopaedics and rehabilitation in Poland.

  5. Long Sick Leave after Orthopaedic Inpatient Rehabilitation: Treatment Failure or Relapse? (United States)

    Mangels, Marija; Schwarz, Susanne; Worringen, Ulrike; Holme, Martin; Rief, Winfried


    We investigated whether short-term versus long-term sick leave after orthopaedic inpatient rehabilitation can be predicted by initial assessment information, the clinical status at discharge, or whether the follow-up interval is crucial for later sick leave. We examined 214 patients from an orthopaedic rehabilitation hospital at admission,…

  6. Operating Room Supply Costs in Orthopaedic Trauma: Cost Containment Opportunities. (United States)

    Gurnea, Taylor P; Frye, Wesley P; Althausen, Peter L


    In the current health care environment, cost containment is more important than ever. Most physicians currently are unaware of the cost of operating room supplies. A large amount of waste occurs secondary to lack of knowledge and absence of physician incentives for cost saving. Many of the decisions for supply use can be based on good scientific evidence, which supports specific cost saving measures. Careful attention to blood utilization and use of tranexamic acid has the potential to save millions in the hip fracture treatment and arthroplasty treatments. Standardization of surgical preparation and draping can decrease costs and prevent costly surgical site infections. Following protocols and guidelines for bone graft and orthobiologics is critical. The clinical and legal repercussions of retained instruments and costs associated with dropped implants is a huge source of wasted health care dollars. Reprocessing programs for external fixators and tourniquets have been extremely successful. A myriad of opportunities for intraoperative cost savings exist that could be applied to nearly every orthopaedic surgery performed in the United States. It is incumbent on all surgeons to put aside the choices made out of habit and take part in reducing operating room waste for the benefit of hospitals, patients, and the health care system. When applied to the 5.3 million orthopaedic surgeries performed annually in the United States, billions of dollars could easily be saved with no adverse effect on patient care.

  7. Assessing readability of patient education materials: current role in orthopaedics. (United States)

    Badarudeen, Sameer; Sabharwal, Sanjeev


    Health literacy is the single best predictor of an individual's health status. It is important to customize health-related education material to the individual patient's level of reading skills. Readability of a given text is the objective measurement of the reading skills one should possess to understand the written material. In this article, some of the commonly used readability assessment tools are discussed and guidelines to improve the comprehension of patient education handouts are provided. Where are we now? Several healthcare organizations have recommended the readability of patient education materials be no higher than sixth- to eighth-grade level. However, most of the patient education materials currently available on major orthopaedic Web sites are written at a reading level that may be too advanced for comprehension by a substantial proportion of the population. WHERE DO WE NEED TO GO?: There are several readily available and validated tools for assessing the readability of written materials. While use of audiovisual aids such as video clips, line drawings, models, and charts can enhance the comprehension of a health-related topic, standard readability tools cannot construe such enhancements. HOW DO WE GET THERE?: Given the variability in the capacity to comprehend health-related materials among individuals seeking orthopaedic care, stratifying the contents of patient education materials at different levels of complexity will likely improve health literacy and enhance patient-centered communication.

  8. Rejection Study of Cancelous Allograft in Emergency Orthopaedic Operation

    International Nuclear Information System (INIS)

    Manjas, Menkher; Hilmy Nazly


    The fast development of national and international tissue bank, increased the use of bone allografts in orthopaedic surgery including emergency open reduction and internal fixation at fresh bone fractures. The aim of this work is to evaluate rejection and usefulness of cancelous bone allografts which have been used in emergency orthopaedic operation. Dwing February until June 2000 two group of 20 patients each, were studied. after preferring emergency open reduction and internal fixation. The first group was treated with cancelous allograft transplantation at the site of the fracture, but the second group did not get any graft. Radiation sterilized allograft were used at this study. Parameters observed were local reaction of wound operation, local rejection and callus formation. The results show that there is no rejection of cancelous bone allograft detected from local and systemic reaction of wound operation. After three week, operation there was no significant different number of callus formation can be detected by conventional radiology examination but after 6 weeks there was a significant increasing in number of callus formation in the group of cancelous allograft transplantation (P < 0.05)

  9. Pudendal nerve palsy in trauma and elective orthopaedic surgery. (United States)

    Polyzois, Ioannis; Tsitskaris, Konstantinos; Oussedik, Sam


    The incidence of pudendal nerve palsy following routine trauma and elective orthopaedic surgery procedures ranges from 1.9% to 27.6%. Excessive and/or prolonged traction against the perineal post of a traction table, leading to direct compression and localised ischaemia to the nerve are suggested mechanisms of injury. Misuse of traction and the inappropriate placement of the perineal post, leading to crushing and stretching of the pudendal nerve, are two main contributing factors leading to its postoperative palsy. The sequelae may be sensory, motor or mixed. In most cases, these injuries are transient and tend to resolve within several weeks or months. However, complete neurological recovery may be unpredictable and the effects of ongoing dysfunction potentially disastrous for the individual. In terms of preventative measures, magnitude and duration of traction time should be minimised; traction should be limited to the critical operative steps only. Additionally, the perineal post should be placed between the genitalia and the contralateral leg. A well-padded, large-diameter perineal post should be used (>10cm). Adequate muscle relaxation during anaesthesia is particularly important in young men who have strong muscles and thus require larger traction forces when compared to elderly patients. Orthopaedic surgeons should be aware of the pathophysiology behind the development of this palsy and the measures that can be employed to reduce its occurrence. In procedures where a traction table is employed, consenting for pudendal nerve palsy should be considered by the surgical team. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. The effect of inclement weather on trauma orthopaedic workload.

    LENUS (Irish Health Repository)

    Cashman, J P


    BACKGROUND: Climate change models predict increasing frequency of extreme weather. One of the challenges hospitals face is how to make sure they have adequate staffing at various times of the year. AIMS: The aim of this study was to examine the effect of this severe inclement weather on hospital admissions, operative workload and cost in the Irish setting. We hypothesised that there is a direct relationship between cold weather and workload in a regional orthopaedic trauma unit. METHODS: Trauma orthopaedic workload in a regional trauma unit was examined over 2 months between December 2009 and January 2010. This corresponded with a period of severe inclement weather. RESULTS: We identified a direct correlation between the drop in temperature and increase in workload, with a corresponding increase in demand on resources. CONCLUSIONS: Significant cost savings could be made if these injuries were prevented. While the information contained in this study is important in the context of resource planning and staffing of hospital trauma units, it also highlights the vulnerability of the Irish population to wintery weather.

  11. Complex orthopaedic management of patients with skeletal dysplasias

    Directory of Open Access Journals (Sweden)

    A. G. Baindurashvili


    Full Text Available Skeletal dysplasias are challenging for diagnostics and treatment. We present a series of fifteen patients with different forms of skeletal dysplasias with age ranged from 6 to 17 years with variable clinical presentations managed as a part of the project of scientific cooperation between Turner Paediatric Orthopaedic Institute and Orthopaedic Hospital Vienna-Speising. The spectrum of diagnoses included multiple epiphyseal dysplasia, spondyloepiphyseal dysplasia congenita, diastrophic dysplasia, metaphyseal dysplasia, spondylometaphyseal dysplasia, Stickler syndrome, Kniest dysplasia, and anauxetic dysplasia. Complex treatment, which included axial correction and juxta-articular realignment, was performed as a single-stage, or consecutive surgery. Surgical techniques included corrective osteotomies with internal fixation, guided growth technique and external fixation devices. Best results (full axial correction, normal alignment of the joint were achieved in 8 patients, including 2 patients with metaphyseal dysplasia, 2 patients with multiple epyphyseal dysplasia, 2 patients with spondyloepyphyseal dysplasia, patient with Stickler syndrome and patient with spondylometaphyseal dysplasia. Good results (partial correction at the present time were seen in 4 patients (2 patients with Kniest dysplasia, 1 - with multiple epyphyseal dysplasia and 1 - with anauxetic dysplasia. Satisfactory results (non-progressive condition in previous progression were obtained in 2 patients with diastrophic dysplasia, and poor results (progression of the deformity - in 1 patient with diastrophic dysplasia. Positive results in most of the cases of our series make promising future for usage of complex approach for orthopedic management of children with skeletal dysplasias; advanced international cooperation is productive and helpful for diagnostics and management of rare diseases.

  12. Molecular Solid EOS based on Quasi-Harmonic Oscillator approximation for phonons

    Energy Technology Data Exchange (ETDEWEB)

    Menikoff, Ralph [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)


    A complete equation of state (EOS) for a molecular solid is derived utilizing a Helmholtz free energy. Assuming that the solid is nonconducting, phonon excitations dominate the specific heat. Phonons are approximated as independent quasi-harmonic oscillators with vibrational frequencies depending on the specific volume. The model is suitable for calibrating an EOS based on isothermal compression data and infrared/Raman spectroscopy data from high pressure measurements utilizing a diamond anvil cell. In contrast to a Mie-Gruneisen EOS developed for an atomic solid, the specific heat and Gruneisen coefficient depend on both density and temperature.

  13. Orthopaedic nurses' attitudes towards clinical nursing research - A cross-sectional survey

    DEFF Research Database (Denmark)

    Berthelsen, Connie Bøttcher; Hølge-Hazelton, Bibi


    The call for evidence-based knowledge in clinical nursing practice has increased during recent decades and research in orthopaedic nursing is needed to improve patients' conditions, care and treatment. A descriptive cross-sectional survey was conducted to determine the self-perceived theoretical...... knowledge and practical research competencies among orthopaedic nurses and their interest and motivation to increase these in everyday practice. A newly developed questionnaire was given to a convenience sample of 87 orthopaedic nurses. Forty three orthopaedic nurses (49.4%) completed the questionnaire....... The results indicated that despite the majority of orthopaedic nurses having low self-perceived theoretical knowledge and practical research competencies, their interest and motivation to improve these were high, especially their inner motivation. However, the nurses' inner motivation was inhibited by a lack...

  14. A VidEo-Based Intelligent Recognition and Decision System for the Phacoemulsification Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Shu Tian


    Full Text Available The phacoemulsification surgery is one of the most advanced surgeries to treat cataract. However, the conventional surgeries are always with low automatic level of operation and over reliance on the ability of surgeons. Alternatively, one imaginative scene is to use video processing and pattern recognition technologies to automatically detect the cataract grade and intelligently control the release of the ultrasonic energy while operating. Unlike cataract grading in the diagnosis system with static images, complicated background, unexpected noise, and varied information are always introduced in dynamic videos of the surgery. Here we develop a VidEo-Based Intelligent Recognitionand Decision (VEBIRD system, which breaks new ground by providing a generic framework for automatically tracking the operation process and classifying the cataract grade in microscope videos of the phacoemulsification cataract surgery. VEBIRD comprises a robust eye (iris detector with randomized Hough transform to precisely locate the eye in the noise background, an effective probe tracker with Tracking-Learning-Detection to thereafter track the operation probe in the dynamic process, and an intelligent decider with discriminative learning to finally recognize the cataract grade in the complicated video. Experiments with a variety of real microscope videos of phacoemulsification verify VEBIRD’s effectiveness.

  15. Discrimination And Biophysical Characterization Of Brazilian Cerrado Physiognomies With Eo-1 Hyperspectral Hyperion (United States)

    Miura, Tomoaki; Huete, Alfredo R.; Ferreira, Laerte G.; Sano, Edson E.


    The savanna, typically found in the sub-tropics and seasonal tropics, are the dominant vegetation biome type in the southern hemisphere, covering approximately 45% of the South America. In Brazil, the savanna, locally known as "cerrado," is the most intensely stressed biome with both natural environmental pressures (e.g., the strong seasonality in weather, extreme soil nutrient impoverishment, and widespread fire occurrences) and rapid/aggressive land conversions (Skole et al., 1994; Ratter et al., 1997). Better characterization and discrimination of cerrado physiognomies are needed in order to improve understanding of cerrado dynamics and its impact on carbon storage, nutrient dynamics, and the prospect for sustainable land use in the Brazilian cerrado biome. Satellite remote sensing have been known to be a useful tool for land cover and land use mapping (Rougharden et al., 1991; Hansen et al., 2000). However, attempts to discriminate and classify Brazilian cerrado using multi-spectral sensors (e.g., Landsat TM) and/or moderate resolution sensors (e.g., NOAA AVHRR NDVI) have often resulted in a limited success due partly to small contrasts depicted in their multiband, spectral reflectance or vegetation index values among cerrado classes (Seyler et al., 2002; Fran a and Setzer, 1998). In this study, we aimed to improve discrimination as well as biophysical characterization of the Brazilian cerrado physiognomies with hyperspectral remote sensing. We used Hyperion, the first satellite-based hyperspectral imager, onboard the Earth Observing-1 (EO-1) platform.

  16. Orthopaedic Trauma Care Capacity Assessment and Strategic Planning in Ghana: Mapping a Way Forward. (United States)

    Stewart, Barclay T; Gyedu, Adam; Tansley, Gavin; Yeboah, Dominic; Amponsah-Manu, Forster; Mock, Charles; Labi-Addo, Wilfred; Quansah, Robert


    Orthopaedic conditions incur more than 52 million disability-adjusted life years annually worldwide. This burden disproportionately affects low and middle-income countries, which are least equipped to provide orthopaedic care. We aimed to assess orthopaedic capacity in Ghana, describe spatial access to orthopaedic care, and identify hospitals that would most improve access to care if their capacity was improved. Seventeen perioperative and orthopaedic trauma care-related items were selected from the World Health Organization's Guidelines for Essential Trauma Care. Direct inspection and structured interviews with hospital staff were used to assess resource availability and factors contributing to deficiencies at 40 purposively sampled facilities. Cost-distance analyses described population-level spatial access to orthopaedic trauma care. Facilities for targeted capability improvement were identified through location-allocation modeling. Orthopaedic trauma care assessment demonstrated marked deficiencies. Some deficient resources were low cost (e.g., spinal immobilization, closed reduction capabilities, and prosthetics for amputees). Resource nonavailability resulted from several contributing factors (e.g., absence of equipment, technology breakage, lack of training). Implants were commonly prohibitively expensive. Building basic orthopaedic care capacity at 15 hospitals without such capacity would improve spatial access to basic care from 74.9% to 83.0% of the population (uncertainty interval [UI] of 81.2% to 83.6%), providing access for an additional 2,169,714 Ghanaians. The availability of several low-cost resources could be better supplied by improvements in organization and training for orthopaedic trauma care. There is a critical need to advocate and provide funding for orthopaedic resources. These initiatives might be particularly effective if aimed at hospitals that could provide care to a large proportion of the population.

  17. Ionizing radiation doses during lower limb torsion and anteversion measurements by EOS stereoradiography and computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Delin, Cyrille, E-mail: [Réseau d’Imagerie Médicale Maussins-Nollet, 114 rue Nollet, 75017 Paris (France); Silvera, Stéphane, E-mail: [Service de Radiologie A, Hôpital Cochin, 27 rue du Faubourg Saint Jacques, 75014 Paris (France); Bassinet, Céline, E-mail: [Institut de Radioprotection et de Sureté Nucléaire, BP 17, 31 Avenue de la Division Leclerc, 92262 Fontenay-aux-Roses Cedex (France); Thelen, Philippe, E-mail: [Réseau d’Imagerie Médicale Maussins-Nollet, 114 rue Nollet, 75017 Paris (France); Rehel, Jean-Luc, E-mail: [Institut de Radioprotection et de Sureté Nucléaire, BP 17, 31 Avenue de la Division Leclerc, 92262 Fontenay-aux-Roses Cedex (France); Legmann, Paul, E-mail: [Service de Radiologie A, Hôpital Cochin, 27 rue du Faubourg Saint Jacques, 75014 Paris (France); Folinais, Dominique, E-mail: [Réseau d’Imagerie Médicale Maussins-Nollet, 114 rue Nollet, 75017 Paris (France)


    Objectives: To calculate and compare the doses of ionizing radiation delivered to the organs by computed tomography (CT) and stereoradiography (SR) during measurements of lower limb torsion and anteversion. Materials and methods: A Rando anthropomorphic phantom (Alderson RANDO phantom, Alderson Research Laboratories Inc., Stanford, Conn) was used for the dose measurements. The doses were delivered by a Somatom 16-slice CT-scanner (Siemens, Erlangen) and an EOS stereoradiography unit (EOS-Imaging, Paris) according to the manufacturers’ acquisition protocols. Doses to the surface and deeper layers were calculated with thermoluminiscent GR207P dosimeters. Dose uncertainties were evaluated and assessed at 6% at k = 2 (that is, two standard deviations). Results: The absorbed doses for the principal organs assessed were as follows: for the ovaries, 0.1 mGy to the right ovary and 0.5 mGy to the left ovary with SR versus1.3 mGy and 1.1 mGy with CT, respectively; testes, 0.3 mGy on the right and 0.4 mGy on the left with SR versus 8.5 mGy and 8.4 mGy with CT; knees, 0.4 mGy to the right knee and 0.8 mGy to the left knee with SR versus 11 mGy and 10.4 mGy with CT; ankles, 0.5 mGy to the right ankle and 0.8 mGy to the left with SR versus 15 mGy with CT. Conclusion: The SR system delivered substantially lower doses of ionizing radiation doses than CT to all the organs studied: CT doses were 4.1 times higher to the ovaries, 24 times higher for the testicles, and 13–30 times higher for the knees and ankles. The use of the SR system to study the torsion of lower limbs makes it possible to reduce the amount of medical irradiation that patients accumulate.

  18. EOS Aura Mission Status at Earth Science Constellation MOWG Meeting @ LASP (Boulder, CO) April 13, 2016 (United States)

    Guit, William J.; Fisher, Dominic


    Presentation reflects EOS Aura mission status, spacecraft subsystems summary, recent and planned activities, inclination adjust maneuvers, propellant usage, orbit maintenance maneuvers, conjunction assessment events, orbital parameters trends and predictions.

  19. Electrostatic Discharge (ESD and Electrical Overstress (EOS: The state of the art in components to systems

    Directory of Open Access Journals (Sweden)

    Steven H. Voldman


    Full Text Available Electrostatic Discharge (ESD, Electrical Overstress (EOS and electromagnetic compatibility (EMC continue to impact semiconductor manufacturing, semiconductor components and systems as technologies scale from micro- to nano-electronics. The range of concern for components include semiconductor components, magnetic recording industry, MEMs, and for products from disk drives, cell phones, notebooks, tablets, laptops, and desktop computers. The objective of this lecture is to address the state of the art of electrostatic discharge (ESD and electrical overstress (EOS in today’s electronic components and systems. The tutorial provides a clear picture of ESD, EOS and EMC phenomena, sources, physics, failure mechanisms, testing and qualification of components and systems. The conclusion of this talk is that ESD and EOS continue to be a concern in technologies from micro-electronics to nano-structures, and will remain a reliability and quality issue in the future.

  20. Advanced E-O test capability for Army Next-Generation Automated Test System (NGATS) (United States)

    Errea, S.; Grigor, J.; King, D. F.; Matis, G.; McHugh, S.; McKechnie, J.; Nehring, B.


    The Future E-O (FEO) program was established to develop a flexible, modular, automated test capability as part of the Next Generation Automatic Test System (NGATS) program to support the test and diagnostic needs of currently fielded U.S. Army electro-optical (E-O) devices, as well as being expandable to address the requirements of future Navy, Marine Corps and Air Force E-O systems. Santa Barbara infrared (SBIR) has designed, fabricated, and delivered three (3) prototype FEO for engineering and logistics evaluation prior to anticipated full-scale production beginning in 2016. In addition to presenting a detailed overview of the FEO system hardware design, features and testing capabilities, the integration of SBIR's EO-IR sensor and laser test software package, IRWindows 4™, into FEO to automate the test execution, data collection and analysis, archiving and reporting of results is also described.

  1. Radiometric cross-calibration of EO-1 ALI with L7 ETM+ and Terra MODIS sensors using near-simultaneous desert observations (United States)

    Chander, Gyanesh; Angal, Amit; Choi, Taeyoung; Xiong, Xiaoxiong


    The Earth Observing-1 (EO-1) satellite was launched on November 21, 2000, as part of a one-year technology demonstration mission. The mission was extended because of the value it continued to add to the scientific community. EO-1 has now been operational for more than a decade, providing both multispectral and hyperspectral measurements. As part of the EO-1 mission, the Advanced Land Imager (ALI) sensor demonstrates a potential technological direction for the next generation of Landsat sensors. To evaluate the ALI sensor capabilities as a precursor to the Operational Land Imager (OLI) onboard the Landsat Data Continuity Mission (LDCM, or Landsat 8 after launch), its measured top-of-atmosphere (TOA) reflectances were compared to the well-calibrated Landsat 7 (L7) Enhanced Thematic Mapper Plus (ETM+) and the Terra Moderate Resolution Imaging Spectroradiometer (MODIS) sensors in the reflective solar bands (RSB). These three satellites operate in a near-polar, sun-synchronous orbit 705 km above the Earth's surface. EO-1 was designed to fly one minute behind L7 and approximately 30 minutes in front of Terra. In this configuration, all the three sensors can view near-identical ground targets with similar atmospheric, solar, and viewing conditions. However, because of the differences in the relative spectral response (RSR), the measured physical quantities can be significantly different while observing the same target. The cross-calibration of ALI with ETM+ and MODIS was performed using near-simultaneous surface observations based on image statistics from areas observed by these sensors over four desert sites (Libya 4, Mauritania 2, Arabia 1, and Sudan 1). The differences in the measured TOA reflectances due to RSR mismatches were compensated by using a spectral band adjustment factor (SBAF), which takes into account the spectral profile of the target and the RSR of each sensor. For this study, the spectral profile of the target comes from the near-simultaneous EO-1

  2. Three-dimensional virtual bone bank system for selecting massive bone allograft in orthopaedic oncology. (United States)

    Wu, Zhigang; Fu, Jun; Wang, Zhen; Li, Xiangdong; Li, Jing; Pei, Yanjun; Pei, Guoxian; Li, Dan; Guo, Zheng; Fan, Hongbin


    Although structural bone allografts have been used for years to treat large defects caused by tumour or trauma, selecting the most appropriate allograft is still challenging. The objectives of this study were to: (1) describe the establishment of a visual bone bank system and workflow of allograft selection, and (2) show mid-term follow-up results of patients after allograft implantation. Allografts were scanned and stored in Digital Imaging and Communications in Medicine (DICOM) files. Then, image segmentation was conducted and 3D model reconstructed to establish a visual bone bank system. Based on the volume registration method, allografts were selected after a careful matching process. From November 2010 to June 2013, with the help of the Computer-assisted Orthopaedic Surgery (CAOS) navigation system, the allografts were implanted in 14 patients to fill defects after tumour resection. By combining the virtual bone bank and CAOS, selection time was reduced and matching accuracy was increased. After 27.5 months of follow-up, the mean Musculoskeletal Tumor Society (MSTS) 93 functional score was 25.7 ± 1.1 points. Except for two patients with pulmonary metastases, 12 patents were alive without evidence of disease at the time this report was written. The virtual bone bank system was helpful for allograft selection, tumour excision and bone reconstruction, thereby improving the safety and effectiveness of limb-salvage surgery.

  3. Unstated factors in orthopaedic decision-making: a qualitative study

    Directory of Open Access Journals (Sweden)

    Learmonth Ian D


    Full Text Available Abstract Background Total joint replacement (TJR of the hip or knee for osteoarthritis is among the most common elective surgical procedures. There is some inequity in provision of TJR. How decisions are made about who will have surgery may contribute to disparities in provision. The model of shared decision-making between patients and clinicians is advocated as an ideal by national bodies and guidelines. However, we do not know what happens within orthopaedic practice and whether this reflects the shared model. Our study examined how decisions are made about TJR in orthopaedic consultations. Methods The study used a qualitative research design comprising semi-structured interviews and observations. Participants were recruited from three hospital sites and provided their time free of charge. Seven clinicians involved in decision-making about TJR were approached to take part in the study, and six agreed to do so. Seventy-seven patients due to see these clinicians about TJR were approached to take part and 26 agreed to do so. The patients' outpatient appointments ('consultations' were observed and audio-recorded. Subsequent interviews with patients and clinicians examined decisions that were made at the appointments. Data were analysed using thematic analysis. Results Clinical and lifestyle factors were central components of the decision-making process. In addition, the roles that patients assigned to clinicians were key, as were communication styles. Patients saw clinicians as occupying expert roles and they deferred to clinicians' expertise. There was evidence that patients modified their behaviour within consultations to complement that of clinicians. Clinicians acknowledged the complexity of decision-making and provided descriptions of their own decision-making and communication styles. Patients and clinicians were aware of the use of clinical and lifestyle factors in decision-making and agreed in their description of clinicians' styles

  4. Spacecraft power system compatibility and stability for the NASA EOS satellite (United States)

    Sable, Dan M.; Cho, Bo H.; Lee, Fred C.


    This paper addresses the problem of system stability of the NASA EOS satellite power system. A potential stability problem exists without a clear specification of the payload input impedance characteristic. Design guidelines are established for the control of the power system and the individual subcomponents to help insure stability with an unknown complex load. A testbed of the EOS power system is employed to verify the analysis.

  5. Earth Observing System (EOS) Aqua and Aura Space Weather Effects on Operational Collision Avoidance (United States)

    Guit, Bill


    This presentation will describe recent EOS Aqua and Aura operational collision avoidance experience during periods of solar and geomagnetic storm activity. It will highlight challenges faced by the operations team during short-notice, high-risk predicted close approaches. The presentation will highlight the evolution of the operational collision avoidance process for the EOS Aqua and Aura missions. The presentation will highlight operational challenges that have occurred, process improvements that have been implemented and identify potential future challenges.

  6. System testing software deployments using Docker and Kubernetes in gitlab CI: EOS + CTA use case

    CERN Multimedia

    CERN. Geneva


    It needs to be seamlessly integrated with `EOS`, which has become the de facto disk storage system at CERN. `CTA` and `EOS` integration requires parallel development of features in both software that needs to be **synchronized and systematically tested** on a specific distributed development infrastructure for each commit in the code base. This presentation describes the full gitlab continuous integration work flow that builds, tests, deploys and run system tests of the full software stack in docker containers on our specific kubernetes infrastructure.

  7. Towards an EO-based Landslide Web Mapping and Monitoring Service (United States)

    Hölbling, Daniel; Weinke, Elisabeth; Albrecht, Florian; Eisank, Clemens; Vecchiotti, Filippo; Friedl, Barbara; Kociu, Arben


    National and regional authorities and infrastructure maintainers in mountainous regions require accurate knowledge of the location and spatial extent of landslides for hazard and risk management. Information on landslides is often collected by a combination of ground surveying and manual image interpretation following landslide triggering events. However, the high workload and limited time for data acquisition result in a trade-off between completeness, accuracy and detail. Remote sensing data offers great potential for mapping and monitoring landslides in a fast and efficient manner. While facing an increased availability of high-quality Earth Observation (EO) data and new computational methods, there is still a lack in science-policy interaction and in providing innovative tools and methods that can easily be used by stakeholders and users to support their daily work. Taking up this issue, we introduce an innovative and user-oriented EO-based web service for landslide mapping and monitoring. Three central design components of the service are presented: (1) the user requirements definition, (2) the semi-automated image analysis methods implemented in the service, and (3) the web mapping application with its responsive user interface. User requirements were gathered during semi-structured interviews with regional authorities. The potential users were asked if and how they employ remote sensing data for landslide investigation and what their expectations to a landslide web mapping service regarding reliability and usability are. The interviews revealed the capability of our service for landslide documentation and mapping as well as monitoring of selected landslide sites, for example to complete and update landslide inventory maps. In addition, the users see a considerable potential for landslide rapid mapping. The user requirements analysis served as basis for the service concept definition. Optical satellite imagery from different high resolution (HR) and very high

  8. Images (United States)

    National Aeronautics and Space Administration — Images for the website main pages and all configurations. The upload and access points for the other images are: Website Template RSW images BSCW Images HIRENASD...

  9. Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda

    Directory of Open Access Journals (Sweden)

    Bouchard Maryse


    Full Text Available Abstract Background Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. Methods A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants’ experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Results Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. Conclusions This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct

  10. Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda (United States)


    Background Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. Methods A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants’ experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Results Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. Conclusions This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct, whistleblower protection, and higher

  11. Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda. (United States)

    Bouchard, Maryse; Kohler, Jillian C; Orbinski, James; Howard, Andrew


    Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants' experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct, whistleblower protection, and higher wages and benefits for workers could be

  12. Eos and the Youth: A Case of Inverted Roles in Rape (United States)

    Dipla, Anthi

    This article examines scenes of Eos pursuing/abducting youths on 5th-century Athenian vases. Eos, the personification of Dawn, is the only woman assuming the role of a pursuer in rape. The theme strangely becomes very popular with vase painters to a degree comparable to ephebes pursuing a woman. The iconography of the scenes is systematically analysed and evaluated. All theories explaining the popularity of the theme from its presumable use as a parable for death are considered. Eos is moreover compared to other winged figures in pursuit that are popular in the same period, especially Sphinx and Eros. Conversely, it is illustrated how Eos' pursuits of youths are thoroughly coined on the same model as ephebe rape scenes. These may have been so popular because they expressed prevalent social notions about how women, like animals,would need subduing/taming by the ephebe, future citizen hunters, before they could assume their appropriate place in society. With Eos the hunter becomes the prey of a wild woman, who has transgressed the control limits set by the social system. Eos is promoted as the ultimate model of what a woman should not be.

  13. Overview of Implant Infections in Orthopaedics Department: Retrospective Study

    Directory of Open Access Journals (Sweden)

    Tugrul Bulut


    Full Text Available In this study, our aim was to evaluate the antibiotic susceptibility of bacteria isolated from orthopedic implant infections. Within two years operated 1996 patients in an orthopedics and traumatology clinic were retrospectively investigated. Seventy-six (76/1996, 3.8% orthopedic implant infections were detected. Isolated bacteria and their antibiotic susceptibility patterns were analyzed. The bacteries isolated from implant related infections and antibiotic sensitivity patterns were evaluated retrospectively in our orthopaedics and traumatology clinic. Staphylococcus aureus was the predominant organism (30.3%. Gram negative bacterias were isolated in 65.8% of our patients. No resistance was determined against vancomycin and linezolid in gram positive bacterias. Imipenem, amicasin and cefepim was seen as the most effective antibiotics for gram negative bacterias.

  14. [The significance of osteoporosis for orthopaedic and trauma surgeons]. (United States)

    Holzer, G


    This refresher is concerned with several aspects: to give an overview over the latest considerations concerning the definition of osteoporosis related to fractures as well as to discuss up-to-date diagnostic possibilities in order to estimate the future fraction risk of the individual patient. Furthermore, it gives a summary of medical treatment options particularly under a orthopaedic and trauma surgery point of view. This topic publication can only be a recurrent presentation synopsis for the purpose of revising, as there are several publications and guidelines for advanced subject-specific training (e.g. S3-Richtlinie zur Diagnose und Therapie der Osteoporose des DVO, Georg Thieme Verlag KG Stuttgart · New York.

  15. Robots in orthopaedic surgery: past, present, and future. (United States)

    Bargar, William L


    Robots are increasingly being developed for use in surgery to aid physicians in providing more precision, especially during procedures requiring fine movements that may be beyond the scope of the human hand. In addition, robots enable the surgeon to provide improved accuracy and reproducibility with the goal of better outcomes. To date, most robotic surgical systems are in the design and experimental stage. For robotic systems to gain widespread acceptance in surgery, they must first prove their value in clinical application and ease of use as well as provide a favorable cost-to-benefit ratio. I provide an overview of the history of robotics in orthopaedic surgery and a review of their current applications with some predictions of the future for this technology. (C) 2007 Lippincott Williams & Wilkins, Inc.

  16. An orthopaedic geriatric rehabilitation unit: the first two years experience. (United States)

    Sainsbury, R; Gillespie, W J; Armour, P C; Newman, E F


    Experience of the first two years of an orthopaedic geriatric rehabilitation unit is described. There were 325 admissions comprising 271 females and 54 males. The predominant diagnosis was fracture of the proximal femur. Average length of stay in the unit was 43 days for males and 36.7 days for females. 75.9% of patients admitted from home returned there and 66.1% of patients admitted from residential care returned to similar accommodation. In the first year there was a fall of 13.5 days in the average length of stay for elderly females with proximal femoral fracture, resulting in 2175 less bed days for this diagnosis. This improvement has continued.

  17. [Management of war orthopaedic injuries in recent armed conflicts]. (United States)

    Frank, M; Mathieu, L


    The extremities continue to be the most frequent sites of wounding during armed conflicts despite the change of combat tactics, soldier armour and battlefield medical support. Due to the advances in prehospital care and timely transport to the hospital, orthopaedic surgeons deal with severe and challenging injuries of the limbs. In contrast to civilian extremity trauma, the most combat-related injuries are open wounds that often have infection-related complications. Data from two recent large armed conflicts (Iraq, Afghanistan) show that extremity injuries are associated with a high complication rate, morbidity and healthcare utilization. A systematic approach that consists of sequential surgical care and good transport capabilities can reduce the complication rate of these injuries. New medical technologies have been implemented in the treatment strategy during the last decade. This article reviews the published scientific data and current opinions on combat-related extremity injuries. Key words: extremity, combat, trauma, medical support system.

  18. Orthopaedic complications associated with sickle-cell disease. (United States)

    de Gheldere, Antoine; Ndjoko, Roger; Docquier, Pierre-Louis; Mousny, Maryline; Rombouts, Jean-Jacques


    Sickle cell disease is the most frequent haemoglobinopathy in the world. It affects mostly African descent, but is also present in whites in Greece, Turkey, Italy and India. The responsible gene is autosomal co-dominant and only individuals homozygous for the gene are symptomatic. The condition is characterised by haemolytic anaemia crises and cardio-pulmonary, digestive, neurological, ocular and osteo-articular manifestations. Osteo-articular complications are frequent and may compromise harmonious growth. This retrospective study reports the osteo-articular complications associated with sickle-cell disease encountered in our institution from 1975 to 2004. Orthopaedic complications were reported in 79 patients out of 325 who were followed with sickle-cell disease.

  19. Subspecialty Training Among Graduates of Pediatric Orthopaedic Fellowships: An 11-Year Analysis of the Database of American Board of Orthopaedic Surgery. (United States)

    Hosseinzadeh, Pooya; Louer, Craig; Sawyer, Jeffrey; Flynn, John; Albanese, Stephen


    The field of pediatric orthopaedic surgery is evolving with a reported increase in the number of pediatric orthopaedic fellows being trained as well as an increase in the number of fellows completing additional fellowship training in another subspecialty. The purpose of this study was to examine the historic trends of trainees seeking multiple fellowships within pediatric orthopaedics over an 11-year period using the database of the American Board of Orthopaedic Surgery (ABOS). We queried the ABOS database for fellowship choice of applicants for the ABOS part II oral examination with the self-declared subspecialty of pediatric orthopaedics during the years of 2005 to 2015. Descriptive analysis was performed to determine the percentage of applicants who completed >1 fellowship, and the type of subspecialty fellowship completed. χ analysis was used to compare the proportion of multiple fellowship trainees between years. From 2005 to 2015, 310 applicants for ABOS part II pediatric subspecialty examination had completed a fellowship in pediatric orthopaedic surgery, with that number increasing from 14 to 43/y over that span. Forty-five trainees (15%) completed 48 additional fellowships over that decade, with 2 recent trainees completing multiple additional fellowships. The most common additional fellowships were sports (n=22, 46%), hand (n=8, 17%), and spine (n=7, 15%). The rate of additional fellowship training increased over 5-fold from 5% in the first 3 years of the study to 28% in the last 2 years of the study (P=0.001). The proportion of trainees completing additional subspecialty fellowships in addition to pediatric orthopaedics has risen over the past decade. The precise cause and effect of such change is uncertain and likely multifactorial. Reexamination of our classic training paradigms may be warranted in light of these trends. Level III.

  20. Development, implementation and evaluation of a patient handoff tool to improve safety in orthopaedic surgery. (United States)

    Gagnier, Joel J; Derosier, Joseph M; Maratt, Joseph D; Hake, Mark E; Bagian, James P


    To develop, implement and test the effect of a handoff tool for orthopaedic trauma residents that reduces adverse events associated with the omission of critical information and the transfer of erroneous information. Components of this project included a literature review, resident surveys and observations, checklist development and refinement, implementation and evaluation of impact on adverse events through a chart review of a prospective cohort compared with a historical control group. Large teaching hospital. Findings of a literature review were presented to orthopaedic residents, epidemiologists, orthopaedic surgeons and patient safety experts in face-to-face meetings, during which we developed and refined the contents of a resident handoff tool. The tool was tested in an orthopaedic trauma service and its impact on adverse events was evaluated through a chart review. The handoff tool was developed and refined during the face-to-face meetings and a pilot implementation. Adverse event data were collected on 127 patients (n = 67 baseline period; n = 60 test period). A handoff tool for use by orthopaedic residents. Adverse events in patients handed off by orthopaedic trauma residents. After controlling for age, gender and comorbidities, testing resulted in fewer events per person (25-27% reduction; P < 0.10). Preliminary evidence suggests that our resident handoff tool may contribute to a decrease in adverse events in orthopaedic patients. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  1. [Orthopaedic surgery residency: comparison between the German and the North American system]. (United States)

    Steckel, H; Musahl, V; Fu, F H; Baums, M H; Schultz, W; Klinger, H M


    On the way to the unification of the European Union (EU), Germany has passed a new medical professional education system at the 106 (th) German medical board in Cologne in 2003. The medical board has established a new residency programme for the specialty of orthopaedic surgery, which was previously separated into orthopaedic and trauma surgery. An exchange of orthopaedic surgeons within the EU is therefore less complicated. For an exchange outside the EU, an international comparison especially with the USA is warranted. We analysed and compared the German "Assistenzarzt System" with the residency programme of the USA regarding the specialty of orthopaedic surgery and further sub-specialisation programmes. After evaluation of both systems, a high conformity in the basic training for orthopaedic surgery was demonstrated. However, there is a difference between the two systems regarding specialisation after residency training with the German "Oberarzt" on the one side and the American fellow system on the other side. This study demonstrates that the German orthopaedic training matches well with the American residency programs. There is potential for acknowledgement of the German title "Orthopaedic surgeon" in the USA. In some states, such as Pennsylvania, European medical specialists are given institutionally restricted work permission for limited periods of time. It remains, however, questionable if there is a general political intent for the USA to acknowledge German or European residency programs.

  2. The Methodology of Clinical Studies Used by the FDA for Approval of High-Risk Orthopaedic Devices. (United States)

    Barker, Jordan P; Simon, Stephen D; Dubin, Jonathan


    The purpose of this investigation was to examine the methodology of clinical trials used by the U.S. Food and Drug Administration (FDA) to determine the safety and effectiveness of high-risk orthopaedic devices approved between 2001 and 2015. Utilizing the FDA's online public database, this systematic review audited study design and methodological variables intended to minimize bias and confounding. An additional analysis of blinding as well as the Checklist to Evaluate a Report of a Nonpharmacological Trial (CLEAR NPT) was applied to the randomized controlled trials (RCTs). Of the 49 studies, 46 (94%) were prospective and 37 (76%) were randomized. Forty-seven (96%) of the studies were controlled in some form. Of 35 studies that reported it, blinding was utilized in 21 (60%), of which 8 (38%) were reported as single-blinded and 13 (62%) were reported as double-blinded. Of the 37 RCTs, outcome assessors were clearly blinded in 6 (16%), whereas 15 (41%) were deemed impossible to blind as implants could be readily discerned on imaging. When the CLEAR NPT was applied to the 37 RCTs, >70% of studies were deemed "unclear" in describing generation of allocation sequences, treatment allocation concealment, and adequate blinding of participants and outcome assessors. This study manifests the highly variable reporting and strength of clinical research methodology accepted by the FDA to approve high-risk orthopaedic devices.

  3. Research on the Influence of Orthopaedic Inserts on Pressure Distribution in the Foot

    Directory of Open Access Journals (Sweden)

    Ignas Rutulys


    Full Text Available The article examines the influence of individual orthopaedic inserts on pressure distribution in the foot. Feet deformations, types of orthopaedic inserts, materials and pressure in the foot testing methods are discussed. Experimental computer measurements of pressure in the foot before and after the use of inserts have been done. During research, the inserts made of different kinds of materials selected according to human weight, pathology, skin sensitivity and many other reasons has been used. It has been determinated that orthopaedic inserts have a more noticeable impact on children whose feet is adjusted easier if compared with those of adults.Article in Lithuanian

  4. The use of three-dimensional printing technology in orthopaedic surgery. (United States)

    Wong, Tak Man; Jin, Jimmy; Lau, Tak Wing; Fang, Christian; Yan, Chun Hoi; Yeung, Kelvin; To, Michael; Leung, Frankie


    Three-dimensional (3-D) printing or additive manufacturing, an advanced technology that 3-D physical models are created, has been wildly applied in medical industries, including cardiothoracic surgery, cranio-maxillo-facial surgery and orthopaedic surgery. The physical models made by 3-D printing technology give surgeons a realistic impression of complex structures, allowing surgical planning and simulation before operations. In orthopaedic surgery, this technique is mainly applied in surgical planning especially revision and reconstructive surgeries, making patient-specific instruments or implants, and bone tissue engineering. This article reviews this technology and its application in orthopaedic surgery.

  5. Integrated Use Of MERIS And Other EO Data For Water Quality And Red Tide Monitoring Along United Arab Emirates Coasts (United States)

    Ceriola, G.; Avgikou, V.; Manunta, P.


    Coastal zones host a large percentage of global population and economical and productive activities and are in need of a constant monitoring. The C-wams project is focused at implementing a suite EO services targeting two growing sectors: Waste Water Treatment and Desalination plants. The coast of the United Arab Emirates (UAE) hosts some of the largest desalination plants in the world and their operation can affect and be affected by the status of the WQ near the coast: the local phenomenon known as Red Tide caused increasing damages in the last 4 years. Some actors are involved in this respect in the Persian gulf, among them the Environment Agency of Abu Dhabi (EAD). In UAE an historical study-case is being performed aimed at identifying Red Tide events using MERIS images, integrating them with other medium and higher resolution data. The present work describes its scenario and the preliminary results obtained.

  6. Using NASA EOS in the Arabian and Saharan Deserts to Examine Dust Particle Size and Spectral Signature of Aerosols (United States)

    Brenton, J. C.; Keeton, T.; Barrick, B.; Cowart, K.; Cooksey, K.; Florence, V.; Herdy, C.; Luvall, J. C.; Vasquez, S.


    Exposure to high concentrations of airborne particulate matter can have adverse effects on the human respiratory system. Ground-based studies conducted in Iraq have revealed the presence of potential human pathogens in airborne dust. According to the Environmental Protection Agency (EPA), airborne particulate matter below 2.5μm (PM2.5) can cause long-term damage to the human respiratory system. Given the relatively high incidence of new-onset respiratory disorders experienced by US service members deployed to Iraq, this research offers a new glimpse into how satellite remote sensing can be applied to questions related to human health. NASA's Earth Observing System (EOS) can be used to determine spectral characteristics of dust particles, the depth of dust plumes, as well as dust particle sizes. Comparing dust particle size from the Sahara and Arabian Deserts gives insight into the composition and atmospheric transport characteristics of dust from each desert. With the use of NASA SeaWiFS DeepBlue Aerosol, dust particle sizes were estimated using Angström exponent. Brightness Temperature Difference (BTD) equation was used to determine the distribution of particle sizes, the area of the dust storm, and whether silicate minerals were present in the dust. The Moderate-resolution Imaging Spectroradiometer (MODIS) on Terra satellite was utilized in calculating BTD. Minimal research has been conducted on the spectral characteristics of airborne dust in the Arabian and Sahara Deserts. Mineral composition of a dust storm that occurred 17 April 2008 near Baghdad was determined using imaging spectrometer data from the Jet Propulsion Laboratory Spectral Library and EO-1 Hyperion data. Mineralogy of this dust storm was subsequently compared to that of a dust storm that occurred over the Bodélé Depression in the Sahara Desert on 7 June 2003.

  7. Cross-calibration of Medium Resolution Earth Observing Satellites by Using EO-1 Hyperion-derived Spectral Surface Reflectance from "Lunar Cal Sites" (United States)

    Ungar, S.


    Over the past 3 years, the Earth Observing-one (EO-1) Hyperion imaging spectrometer was used to slowly scan the lunar surface at a rate which results in up to 32X oversampling to effectively increase the SNR. Several strategies, including comparison against the USGS RObotic Lunar Observatory (ROLO) mode,l are being employed to estimate the absolute and relative accuracy of the measurement set. There is an existing need to resolve discrepancies as high as 10% between ROLO and solar based calibration of current NASA EOS assets. Although the EO-1 mission was decommissioned at the end of March 2017, the development of a well-characterized exoatmospheric spectral radiometric database, for a range of lunar phase angles surrounding the fully illuminated moon, continues. Initial studies include a comprehensive analysis of the existing 17-year collection of more than 200 monthly lunar acquisitions. Specific lunar surface areas, such as a lunar mare, are being characterized as potential "lunar calibration sites" in terms of their radiometric stability in the presence of lunar nutation and libration. Site specific Hyperion-derived lunar spectral reflectance are being compared against spectrographic measurements made during the Apollo program. Techniques developed through this activity can be employed by future high-quality orbiting imaging spectrometers (such as HyspIRI and EnMap) to further refine calibration accuracies. These techniques will enable the consistent cross calibration of existing and future earth observing systems (spectral and multi-spectral) including those that do not have lunar viewing capability. When direct lunar viewing is not an option for an earth observing asset, orbiting imaging spectrometers can serve as transfer radiometers relating that asset's sensor response to lunar values through near contemporaneous observations of well characterized stable CEOS test sites. Analysis of this dataset will lead to the development of strategies to ensure more

  8. An Earth Observation Land Data Assimilation System (EO-LDAS) (United States)

    Gomez-Dans, Jose; Lewis, Philip; Quaife, Tristan; Kaminski, Tomas; Styles, Jon


    In order to monitor the land surface, EO data provides the means of achieving global coverage in a timely fashion. Different sensors orbit the Earth acquiring data at different times and with different spectral and spatial properties. Blending all these observations presents a considerable challenge. Purely statistical methods based on machine learning techniques require accurate and extensive ground truth for "training" models. The complexities of the processes that take place in the scene result in limited usefulness of these models outside their training region or period. Models that describe the physical processes that give rise to the measurements, based on radiative transfer theory, offer a more robust way of interpreting the recorded data and relating it to surface properties such as leaf area index, chlorophyll concentration, etc. Unfortunately, the information content in the signals is rarely sufficient to unambigously determine the many parameters that are required in typical radiative transfer models. To improve on this, the use of prior information is required. Typically, this information is given as parameter ranges, or maybe even distributions, which can have a positive effect in the so-called "inverse problem". Data assimilation techniques allow one to use models of the land surface as priors, to constrain the inverse problem. These models can be very useful in improving the ability of inverting the observations, as the models can give very valuable information on the dynamics of some parameters, like LAI. However, some parameters that have a strong bearing on the observations (some pigments, leaf angle distributions...) have no analogues in typical DGVMs. In this work, we introduce and demonstrate the use of weak constraint 4DVAR data assimilation to the problem of inverting optical RT models. We demonstrate that the use of this technique results in important gains in parameter uncertainty reduction for a typical satellite mission, including

  9. Aquapath-Soil: Supporting farmers with hydrologic models and EO data (United States)

    Chambel-Leitao, Pedro; Almeida, Carina; Jauch, Eduardo; Rosado, Hugo; Rocha, António; Leitão, José; Neves, Ramiro


    The AquaPath-Soil service (support to agricultural production) aims to provide support services for irrigation, based on the use of satellite images, hydrological models and meteorological data. Users can observe the project results through the website page ( maps of Leaf Area Index (LAI), and animated maps of Actual Evapotranspiration (ETA) or receive SMS throughout the period with meteorological information and actual evapotranspiration. The service has been tested for a period of 3 years, and presently has about 80 pivot being covered by the service. The farmers evaluated positively the service and the service will continue in 2013. ETA maps are generated by MOHID LAND model and represent the evapotranspiration accumulated weekly throughout the growing period of maize between May and September, using LAI as input. Both this models (SWAT and MOHID LAND) calculate plant growth, actual evapotranspiration and soil moisture by explicitly calculating water balance of the system soil-plant-atmosphere. The information provided in the SMS is obtained through SWAT model running in forecast mode using meteorological data from the previous week and forecasts for the next week. The weather data is from the closest station of each field (precipitation, temperature, relative humidity, wind speed and solar radiation). The weather forecasts are obtained from the MM5 model ( Models and satellite images have been validated during this last three years using field measurements and farmers support. Main challenge of Aquapath-Soil service is the reduction of operational costs, mainly related with satellite acquisition and processing. The recently approved SenSyF FP7 project will implement a framework to obtain this aim. The SenSyF project proposes a complete system for fully automated data acquisition and processing. The SenSyF project provides a specialized Sandbox Service with tools and development/validation platforms where

  10. Bioactive Coatings for Orthopaedic Implants—Recent Trends in Development of Implant Coatings (United States)

    Zhang, Bill G. X.; Myers, Damian E.; Wallace, Gordon G.; Brandt, Milan; Choong, Peter F. M.


    Joint replacement is a major orthopaedic procedure used to treat joint osteoarthritis. Aseptic loosening and infection are the two most significant causes of prosthetic implant failure. The ideal implant should be able to promote osteointegration, deter bacterial adhesion and minimize prosthetic infection. Recent developments in material science and cell biology have seen the development of new orthopaedic implant coatings to address these issues. Coatings consisting of bioceramics, extracellular matrix proteins, biological peptides or growth factors impart bioactivity and biocompatibility to the metallic surface of conventional orthopaedic prosthesis that promote bone ingrowth and differentiation of stem cells into osteoblasts leading to enhanced osteointegration of the implant. Furthermore, coatings such as silver, nitric oxide, antibiotics, antiseptics and antimicrobial peptides with anti-microbial properties have also been developed, which show promise in reducing bacterial adhesion and prosthetic infections. This review summarizes some of the recent developments in coatings for orthopaedic implants. PMID:25000263

  11. Loneliness and psychological health of orthopaedic patients' caregivers: does gender make a difference? (United States)

    Chukwuorji, JohnBosco Chika; Amazue, Lawrence O; Ekeh, Okechukwu Hope


    Although research evidence indicates that loneliness is detrimental to mental health in diverse populations, impact of loneliness on psychological distress of orthopaedic patients' caregivers has been given little research attention. The present study examined the association of loneliness with psychological health, and explored gender differences in the loneliness and psychological health association among orthopaedic patients' caregivers. Participants were 250 patients' caregivers drawn from a national orthopaedic hospital in eastern Nigeria. Data was collected by means of self-report measures translated into the local dialect of the caregivers. Multiple regression results showed that loneliness positively predicted psychological distress in the total sample. Loneliness did not predict psychological distress of male caregivers, but it positively predicted psychological distress of female caregivers. In order to promote orthopaedic patients caregivers' mental health, gender-based differentials in the link between loneliness and psychological distress should be addressed by researchers and healthcare practitioners.

  12. Bioactive Coatings for Orthopaedic Implants—Recent Trends in Development of Implant Coatings

    Directory of Open Access Journals (Sweden)

    Bill G. X. Zhang


    Full Text Available Joint replacement is a major orthopaedic procedure used to treat joint osteoarthritis. Aseptic loosening and infection are the two most significant causes of prosthetic implant failure. The ideal implant should be able to promote osteointegration, deter bacterial adhesion and minimize prosthetic infection. Recent developments in material science and cell biology have seen the development of new orthopaedic implant coatings to address these issues. Coatings consisting of bioceramics, extracellular matrix proteins, biological peptides or growth factors impart bioactivity and biocompatibility to the metallic surface of conventional orthopaedic prosthesis that promote bone ingrowth and differentiation of stem cells into osteoblasts leading to enhanced osteointegration of the implant. Furthermore, coatings such as silver, nitric oxide, antibiotics, antiseptics and antimicrobial peptides with anti-microbial properties have also been developed, which show promise in reducing bacterial adhesion and prosthetic infections. This review summarizes some of the recent developments in coatings for orthopaedic implants.

  13. Empowering the rural poor through EO products and services—An impact assessment (United States)

    Diwakar, P. G.; Ranganath, B. K.; Gowrisankar, D.; Jayaraman, V.


    With the advent of technology in the form of space-based imaging, network-based computation and information technology, the focus has shifted to how these technologies could change the livelihoods of rural community and put them on the path of developmental processes. Many rural villages in India do not have right kind of infrastructure and connectivity, which makes it difficult for any developmental program to perform successfully. This makes them more vulnerable and further cut off from the mainstream developmental programs in the country. There are large tracts of arid and semi-arid lands in many parts of the country, which requires scientific inputs and improved farming practices for sustenance of poor communities under tough conditions. Unless some simple and cost-effective methods are evolved and taken to the field level, it is difficult to see positive developments in such areas and stop people from migrating to different areas for livelihood options. Integrated watershed development program with innovative practices and holistic approach could bring about positive changes in such poverty stricken areas that host vulnerable groups who experience the hardship due to poor local natural resources conditions and living standards. An optimal combination of space technology and information technology has been successfully used, through participatory methods, to empower the rural poor in realizing better livelihood possibilities. An attempt is made in this paper to find solutions for such problematic areas with some innovative tools and techniques that involve user-friendly delivery of EO products and services for the benefit of the rural community and help them in decision making at local level.

  14. End-of-life (EoL) mobile phone management in Hong Kong households. (United States)

    Deng, Wen-Jing; Giesy, John P; So, C S; Zheng, Hai-Long


    A questionnaire survey and interviews were conducted in households and end-of-life (EoL) mobile phone business centres in Hong Kong. Widespread Internet use, combined with the rapid evolution of modern social networks, has resulted in the more rapid obsolescence of mobile phones, and thus a tremendous increase in the number of obsolete phones. In 2013, the volume of EoL mobile phones generated in Hong Kong totalled at least 330 tonnes, and the amount is rising. Approximately 80% of electronic waste is exported to Africa and developing countries such as mainland China or Pakistan for recycling. However, the material flow of the large number of obsolete phones generated by the territory's households remains unclear. Hence, the flow of EoL mobile phones in those households was analysed, with the average lifespan of a mobile phone in Hong Kong found to be just under two years (nearly 23 months). Most EoL mobile phones are transferred to mainland China for disposal. Current recycling methods are neither environmentally friendly nor sustainable, with serious implications for the environment and human health. The results of this analysis provide useful information for planning the collection system and facilities needed in Hong Kong and mainland China to better manage EoL mobile phones in the future. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Morphological segmentation for sagittal plane image analysis. (United States)

    Bezerra, F N; Paula, I C; Medeiros, F S; Ushizima, D M; Cintra, L S


    This paper introduces a morphological image segmentation method by applying watershed transform with markers to scale-space smoothed images and furthermore provides images for clinical monitoring and analysis of patients. The database comprises sagittal plane images taken from a digital camera of patients submitted to Global Postural Reeducation (GPR) physiotherapy treatment. Orthopaedic specialists can use these segmented images to diagnose posture problems, assess physiotherapy treatment evolution and thus reduce diagnostic errors due to subjective analysis.

  16. Evaluation of the orthopaedics and traumatology resident education in Turkey: A descriptive study. (United States)

    Huri, Gazi; Cabuk, Yusuf Sertan; Gursoy, Safa; Akkaya, Mustafa; Ozkan, Secil; Oztuna, Volkan; Aydingoz, Onder; Senkoylu, Alparslan


    The objective of this study is to describe the current situation regarding the training, working conditions, future plans, fields of interest and satisfaction of orthopaedics and traumatology residents in Turkey. A descriptive survey questionnaire consisting of 24 questions was designed to identify the problems and solution suggestions concerning training of orthopaedic residents. All orthopaedics and traumatology residents who took the 2013 Progress Testing for Speciality in Medicine (UEGS) held by Turkish Orthopaedics and Traumatology Education Council (TOTEK) were surveyed in the class at the end thereof as well as the young orthopaedic surgeons who were reached through the email groups of Turkish Society of Orthopaedics and Traumatology - Residents and Young Attendings Council (TOTBID-AGUH). A total of 725 residents and 132 young attendings were surveyed. The most outstanding answers are as follows: 62,7% of the respondents replied to the question "Is there a training program/Is it being applied" as "yes/yes". It was found out that 94,3% of the respondents wanted to be involved in a rotation abroad. The "patient care" was the most common answer, with a ratio of 36,9%, to the question "What's the priority of the department you are studying in?". Regarding work conditions, "many emergency on-calls" was found to be the most important parameter affecting life conditions (p < 0.05). Aiming to identify the challenges that orthopaedics and traumatology residents in Turkey face as regards their training, this survey stands as a pioneering study with a high participation rate. Analysis of survey data highlights the importance of several key factors such as the development of training programs and increasing the time spent with academicians as well as spreading and promotion of log book application. Copyright © 2016 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

  17. "Is There An App For That?" Orthopaedic Patient Preferences For A Smartphone Application. (United States)

    Datillo, Jonathan R; Gittings, Daniel J; Sloan, Matthew; Hardaker, William M; Deasey, Matthew J; Sheth, Neil P


    Patients are seeking out medical information on the Internet and utilizing smartphone health applications ("apps"). Smartphone use has exponentially increased among orthopaedic surgeons and patients. Despite this increase, patients are rarely directed to specific apps by physicians. No study exists querying patient preferences for a patient-centered, orthopaedic smartphone application. The purpose of this study is to 1) determine Internet use patterns amongst orthopaedic patients; 2) ascertain access to and use of smartphones; and 3) elucidate what features orthopaedic patients find most important in a smartphone application. We surveyed patients in an orthopaedic practice in an urban academic center to assess demographics, access to and patterns of Internet and Smartphone use, and preferences for features in a smartphone app. A total of 310 surveys were completed. Eighty percent of patients reported Internet access, and 62% used the Internet for health information. Seventy-seven percent owned smartphones, 45% used them for health information, and 28% owned health apps. Only 11% were referred to an app by a physician. The highest ranked features were appointment reminders, ability to view test results, communication with physicians, and discharge instructions. General orthopaedic information and pictures or videos explaining surgery were the 2 lowest ranked features. Seventy-one percent of patients felt an app with some of the described features would improve their healthcare experiences, and 40% would pay for the app. The smartphone is an under-utilized tool to enhance patient-physician communication, increase satisfaction, and improve quality of care. Patients were enthusiastic about app features that are often included in patient health portals, but ranked orthopaedic educational features lowest. Further study is required to elucidate how best to use orthopaedic apps as physician-directed educational opportunities to promote patient satisfaction and quality of

  18. Feasibility of and Rationale for the Collection of Orthopaedic Trauma Surgery Quality of Care Metrics. (United States)

    Miller, Anna N; Kozar, Rosemary; Wolinsky, Philip


    Reproducible metrics are needed to evaluate the delivery of orthopaedic trauma care, national care, norms, and outliers. The American College of Surgeons (ACS) is uniquely positioned to collect and evaluate the data needed to evaluate orthopaedic trauma care via the Committee on Trauma and the Trauma Quality Improvement Project. We evaluated the first quality metrics the ACS has collected for orthopaedic trauma surgery to determine whether these metrics can be appropriately collected with accuracy and completeness. The metrics include the time to administration of the first dose of antibiotics for open fractures, the time to surgical irrigation and débridement of open tibial fractures, and the percentage of patients who undergo stabilization of femoral fractures at trauma centers nationwide. These metrics were analyzed to evaluate for variances in the delivery of orthopaedic care across the country. The data showed wide variances for all metrics, and many centers had incomplete ability to collect the orthopaedic trauma care metrics. There was a large variability in the results of the metrics collected among different trauma center levels, as well as among centers of a particular level. The ACS has successfully begun tracking orthopaedic trauma care performance measures, which will help inform reevaluation of the goals and continued work on data collection and improvement of patient care. Future areas of research may link these performance measures with patient outcomes, such as long-term tracking, to assess nonunion and function. This information can provide insight into center performance and its effect on patient outcomes. The ACS was able to successfully collect and evaluate the data for three metrics used to assess the quality of orthopaedic trauma care. However, additional research is needed to determine whether these metrics are suitable for evaluating orthopaedic trauma care and cutoff values for each metric.

  19. Industry Financial Relationships in Orthopaedic Surgery: Analysis of the Sunshine Act Open Payments Database and Comparison with Other Surgical Subspecialties. (United States)

    Cvetanovich, Gregory L; Chalmers, Peter N; Bach, Bernard R


    Industry financial relationships for orthopaedic surgeons in the United States are now publicly reported in the Sunshine Act Open Payments database. We sought to present these data in a more easily understandable format and to describe how industry relationships in orthopaedic surgery compare with other surgical subspecialties. The Open Payments database was searched for all records of industry financial relationships for orthopaedic surgeons. Data analyzed included the value of reported financial relationships per surgeon, the type of financial relationship, and geographic region. Similar analytics were collected for neurological surgery, urology, plastic surgery, and otolaryngology. Data were normalized to the overall number of providers in each subspecialty in the United States from the American Medical Association 2012 data. For 12,320 orthopaedic surgeons, 58,127 industry financial relationships were reported, with a total value of $80.2 million. Royalties or licensing fees, which were received by 1.7% of U.S. orthopaedic surgeons, accounted for 69.5% of the total monetary value of payments to orthopaedic surgeons. Between August and December 2013, 50.1% of U.S. orthopaedic surgeons had a reported financial relationship. Orthopaedics had the second lowest percentage of physicians with industry financial relationships among the five surgical subspecialties studied. The overall value of payments per orthopaedic surgeon was higher than in the other subspecialties, driven by the large value of royalties and licensing. One-half of U.S. orthopaedic surgeons have industry financial relationships reported in the Open Payments database. Orthopaedic surgeons are less likely than most surgical subspecialists to receive industry payments, and the majority of the overall value of orthopaedic financial relationships is driven by a small number of orthopaedic surgeons receiving royalties and licensing for reimbursable innovation within the field. Copyright © 2015 by The

  20. Professionalism, social media, and the Orthopaedic Surgeon: What do you have on the Internet? (United States)

    Call, Trevor; Hillock, Ronald


    Unprofessional conduct is detrimental to the Orthopaedic Surgery profession. Currently, no formal guidelines exist to define online professionalism other than the protection of patient confidentiality. This study will extract a random but statistically significant number of practicing Orthopaedic Surgeons and review their online postings. We observed the Internet content posted by 1,021 Orthopaedic Surgeons that were randomly selected from the American Academy of Orthopaedic Surgeons 2013 member directory. Each surgeon's name was entered into the search engine and on Social Media sites including,,, and The content was evaluated and recorded where it was encountered. Unprofessional content was recorded and reviewed by a panel for appropriateness. Of the 1,021 Orthopaedic Surgeons sampled, 82% have professional websites, 4% have professional blogs, 21% have professional Facebook accounts, 14% have professional Twitter accounts, 26% have professional LinkedIn accounts, and 14% have professional YouTube accounts. Unprofessional content was identified in 3.5% of all surgeons sampled who have some form of content on the Internet. Every Orthopaedic Surgeon should be aware of the content posted on the Internet. Our recommendation is for surgeons to routinely evaluate content posted on publically available venues for professionalism.

  1. Orthopaedic Patient Information on the World Wide Web: An Essential Review. (United States)

    Cassidy, John Tristan; Baker, Joseph F


    Patients increasingly use the Internet to research health-related issues. Internet content, unlike other forms of media, is not regulated. Although information accessed online can impact patients' opinions and expectations, there is limited information about the quality or readability of online orthopaedic information. PubMed, MEDLINE, and Google Scholar were searched using anatomic descriptors and three title keywords ("Internet," "web," and "online"). Articles examining online orthopaedic information from January 1, 2000, until April 1, 2015, were recorded. Articles were assessed for the number of reviewers evaluating the online material, whether the article examined for a link between authorship and quality, and the use of recognized quality and readability assessment tools. To facilitate a contemporary discussion, only publications since January 1, 2010, were considered for analysis. A total of thirty-eight peer-reviewed articles published since 2010 examining the quality and/or readability of online orthopaedic information were reviewed. For information quality, there was marked variation in the quality assessment methods utilized, the number of reviewers, and the manner of reporting. To date, the majority of examined information is of poor quality. Studies examining readability have focused on pages produced by professional orthopaedic societies. The quality and readability of online orthopaedic information are generally poor. For modern practices to adapt to the Internet and to prevent misinformation, the orthopaedic community should develop high-quality, readable online patient information. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

  2. Liquid–liquid equilibria for reservoir fluids+monoethylene glycol and reservoir fluids+monoethylene glycol+water: Experimental measurements and modeling using the CPA EoS

    DEFF Research Database (Denmark)

    Frost, Michael; Kontogeorgis, Georgios; Stenby, Erling Halfdan


    The complex phase equilibrium between reservoir fluids and associating compounds like water and glycols has become more and more important as the increasing global energy demand pushes the oil industry to use advanced methods to increase oil recovery, such as increasing the use of various chemicals....... Promising results are also obtained with CPA EoS for ternary mixtures, with some deviations for the solubility of MEG/water in the hydrocarbon phase and for the hydrocarbons in the polar phase....... to ensure a constant and safe production. The CPA equation of state has been successfully applied in the past to well defined systems and gas condensates, containing associating compounds. It has also been extended to reservoir fluids in presence of water and polar chemicals using modified correlations...

  3. Distribution of MEG and methanol in well-defined hydrocarbon and water systems: Experimental measurement and modeling using the CPA EoS

    DEFF Research Database (Denmark)

    Riaz, Muhammad; Yussuf, Mustafe A.; Kontogeorgis, Georgios


    Liquid-liquid equilibria data for two binary and two ternary systems are reported in the temperature range of 303.15-323.15. K at atmospheric pressure. The binary systems measured are n-nonane + MEG and ethylbenzene + MEG and the ternary systems are n-nonane + MEG + water and ethylbenzene + MEG...... + water. These data are satisfactorily correlated (binaries) and predicted (ternaries) using Cubic Plus Association (CPA) equation of state (EoS). CPA is also applied to binary LLE of aromatic hydrocarbon + water and VLE of methane + methanol. Finally the distribution of water and inhibitors (methanol...... and MEG) in various phases is modeled using CPA. The hydrocarbon phase consists of mixture-1 (methane, ethane, n-butane) or mixture-2 (methane, ethane, propane, n-butane, n-heptane, toluene and n-decane). CPA can satisfactorily predict the water content in the gas phase of the multicomponent systems...

  4. Application of the PFV EoS correlation to excess molar volumes of (1-ethyl-3-methylimidazolium ethylsulfate + alkanols) at different temperatures

    International Nuclear Information System (INIS)

    Deenadayalu, N.; Sen, S.; Sibiya, P.N.


    The experimental densities for the binary systems of an ionic liquid and an alkanol {1-ethyl-3-methylimidazolium ethylsulfate [EMIM] + [EtSO 4 ] - + methanol or 1-propanol or 2-propanol} were determined at T = (298.15, 303.15, and 313.15) K. The excess molar volumes for the above systems were then calculated from the experimental density values for each temperature. The Redlich-Kister smoothing polynomial was used to fit the experimental results and the partial molar volumes were determined from the Redlich-Kister coefficients. For all the systems studied, the excess molar volume results were negative over the entire composition range for all the temperatures. The excess molar volumes were correlated with the pentic four parameter virial (PFV) equation of state (EoS) model

  5. Polystyrene Foam EOS as a Function of Porosity and Fill Gas (United States)

    Mulford, Roberta; Swift, Damian


    An accurate EOS for polystyrene foam is necessary for analysis of numerous experiments in shock compression, inertial confinement fusion, and astrophysics. Plastic to gas ratios vary between various samples of foam, according to the density and cell-size of the foam. A matrix of compositions has been investigated, allowing prediction of foam response as a function of the plastic-to-air ratio. The EOS code CHEETAH allows participation of the air in the decomposition reaction of the foam, Differences between air-filled, nitrogen-blown, and CO2-blown foams are investigated, to estimate the importance of allowing air to react with plastic products during decomposition. Results differ somewhat from the conventional EOS, which are generated from values for plastic extrapolated to low densities.

  6. An European framework for the long term preservation of EO data (United States)

    Forcada, E.; Albani, M.; Beruti, V.


    The need for accessing historical Earth Observation (EO) data series strongly increased in the last ten years, mainly for long term science and environmental monitoring applications. This trend is likely to increase even more in the future in particular for the growing interest on global change monitoring that requires data time-series spanning 20 years and more, and for the need to support the United Nations Framework Convention on Climate Change (UNFCCC). Content of EO data archives is extending from a few years to decades and their scientific value is continuously increasing hence is well recognized the need to preserve them without time limitation and to keep the archived EO data well accessible and exploitable as they constitute a humankind asset. The large amount of new Earth Observation missions upcoming in the next years will moreover lead to a major increase of EO data volumes. This fact, together with the increased demands from the scientific user community, marks a challenge for Earth Observation satellite operators, Space Agencies and EO data providers regarding coherent data preservation and optimum availability and accessibility of the different data products. Traditionally in Europe, there has been poor cooperation in this field with no common approach for long term preservation and access to EO space data even if cooperation and sharing are key aspects to be pursued for the benefit of the user community. Single organizations have difficulties to afford data preservation in the long term that calls for the need of optimising costs and efforts, identifying commonalities. In 2006, the European Space Agency (ESA) initiated a coordination action to share among all the European (and Canadian) stakeholders a common approach to the long term preservation of Earth Observation data. During 2007, the Agency started consultations with its Member States presenting an EO Long Term Data Preservation (LTDP) strategy targeting the preservation of all European

  7. Orthopaedic Considerations for the Adult With Osteogenesis Imperfecta. (United States)

    Roberts, Timothy T; Cepela, Daniel J; Uhl, Richard L; Lozman, Jeffery


    Osteogenesis imperfecta is a heritable group of collagen-related disorders that affects up to 50,000 people in the United States. Although the disease is most symptomatic in childhood, adults with osteogenesis imperfecta also are affected by the sequelae of the disease. Orthopaedic manifestations include posttraumatic and accelerated degenerative joint disease, kyphoscoliosis, and spondylolisthesis. Other manifestations of abnormal collagen include brittle dentition, hearing loss, cardiac valve abnormalities, and basilar invagination. In general, nonsurgical treatment is preferred for management of acute fractures. High rates of malunion, nonunion, and subsequent deformity have been reported with both closed and open treatment. When surgery is necessary, surgeons should opt for load-sharing intramedullary devices that span the entire length of the bone; locking plates and excessively rigid fixation generally should be avoided. Arthroplasty may be considered for active patients, but the procedure frequently is associated with complications in this patient population. Underlying deformities, such as malunion, bowing, rotational malalignment, coxa vara, and acetabular protrusio, pose specific surgical challenges and underscore the importance of preoperative planning.

  8. [Richard von Volkmann, one career of orthopaedic surgeon and poet]. (United States)

    Bumbasirević, M; Lesić, A; Sudjić, V; Zagorac, S


    Richard von Volkman was one of the most famous and important surgeons in the 19th century. He pioneered antiseptic procedures and was especially known for his achivements in orthopedic surgery. Von Volkmann was born in Leipzig, Germany and attended medical schools in Giessen, Halle, and Berlin. Starting in 1867, he worked as a professor of surgery at the University of Halle, also leading its surgical clinic. He was active as a surgeon during Seven Weeks' War with Austria in 1866 and the Franco-Prussian war 1870/1871, in the latter as consulting Generalarzt. He was important in the introduction of antiseptic wound treatment in Germany, and through it to the United States of America. Two observations in orthopaedic surgery bear his name to these days: Volkmans contracture and Heuter-Volkmans low. Volkmann also wrote poetry under the name Richard Leander and his book entitled "Dreams by French Firesides" which still has a place in literature. He died of paralysis due to a chronic spinal disease, following a prolonged illness, in the Binswanger institution in Jena in 1889, at the top of his careere.

  9. Improving operation notes to meet British Orthopaedic Association guidelines. (United States)

    Morgan, David; Fisher, Noel; Ahmad, Aman; Alam, Fazle


    Operation notes are an important part of medical records for clinical, academic and medicolegal reasons. This study audited the quality of operative note keeping for total knee replacements against the standards set by the British Orthopaedic Association (BOA). A prospective review of all patients undergoing total knee replacement at a district general hospital over 8 months. Data recorded were compared with those required by the BOA good-practice guidelines. Change in practice was implemented and the audit cycle completed. Data were statistically analysed. A total of 129 operation notes were reviewed. There was a significant improvement in the mean number of data points recorded from 9.6 to 13.1. The least well recorded data were diagnosis, description of findings, alignment and postoperative flexion range. All had a significant improvement except description of findings. The operating surgeon writing the note improved from 56% to 67%. Detailed postoperative instructions also improved in quality. Surgeon education and the use of a checklist produce better quality total knee replacement operation notes in line with BOA guidelines. Further improvements may be made by making the data points part of the operation note itself.

  10. Patient radiation doses in various fluoroscopically guided orthopaedic procedures

    International Nuclear Information System (INIS)

    Tsapaki, V.; Fagkrezos, D.; Tsalafoutas, I. A.; Lazaretos, I.; Nikolaou, V.S.; Efstathopoulos, N.


    All orthopaedic fluoroscopic procedures performed using C-arm guidance were monitored for 1 y. The type of procedure, fluoroscopy time (T), kerma-area product (KAP) values and number of radiographs (F) were recorded. The two most often performed techniques were as follows: intramedullary nailing (IMN) of intertrochanteric/peritrochanteric (IP) fractures (101 cases, 49.3 %) and antergrade IMN of femur or tibia shaft (TS) fractures (28 cases, 13.7 %). For the remaining procedures, none accounted for >5 %, categorised as 'various' (76 cases, 37 %). Large variations in T, KAP and F were observed. For IMN of IP fractures, antergrade IMN of femur and TS fractures and for various procedures, respectively, median values were T-2.1, 2.2 and 0.6 min, KAP-6.3, 6.3 and 0.6 Gy cm-2 and F-21, 2.2 and 6.7. The patient doses during fluoroscopically guided procedures are relatively low compared with other interventional procedures. (authors)

  11. An ultrasonic orthopaedic surgical device based on a cymbal transducer. (United States)

    Bejarano, Fernando; Feeney, Andrew; Wallace, Robert; Simpson, Hamish; Lucas, Margaret


    An ultrasonic orthopaedic surgical device is presented, where the ultrasonic actuation relies on a modification of the classical cymbal transducer. All current devices consist of a Langevin ultrasonic transducer with a tuned cutting blade attached, where resonance is required to provide sufficient vibrational amplitude to cut bone. However, this requirement restricts the geometry and offers little opportunity to propose miniaturised devices or complex blades. The class V flextensional cymbal transducer is proposed here as the basis for a new design, where the cymbal delivers the required vibrational amplitude, and the design of the attached cutting insert can be tailored for the required cut. Consequently, the device can be optimised to deliver an accurate and precise cutting capability. A prototype device is presented, based on the cymbal configuration and designed to operate at 25.5kHz with a displacement amplitude of 30μm at 300V. Measurements of vibrational and impedance responses elucidate the mechanical and electrical characteristics of the device. Subsequent cutting tests on rat femur demonstrate device performance consistent with a commercial Langevin-based ultrasonic device and show that cutting is achieved using less electrical power and a lower piezoceramic volume. Histological analysis exhibits a higher proportion of live cells in the region around the cut site for the cymbal device than for a powered sagittal or a manual saw, demonstrating the potential for the ultrasonic device to result in faster healing. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  12. Ambulatory orthopaedic surgery patients' knowledge with internet-based education. (United States)

    Heikkinen, Katja; Leino-Kilpi, H; Salanterä, S


    There is a growing need for patient education and an evaluation of its outcomes. The aim of this study was to compare ambulatory orthopaedic surgery patients' knowledge with Internet-based education and face-to-face education with a nurse. The following hypothesis was proposed: Internet-based patient education (experiment) is as effective as face-to-face education with a nurse (control) in increasing patients' level of knowledge and sufficiency of knowledge. In addition, the correlations of demographic variables were tested. The patients were randomized to either an experiment group (n = 72) or a control group (n = 75). Empirical data were collected with two instruments. Patients in both groups showed improvement in their knowledge during their care. Patients in the experiment group improved their knowledge level significantly more in total than those patients in the control group. There were no differences in patients' sufficiency of knowledge between the groups. Knowledge was correlated especially with patients' age, gender and earlier ambulatory surgeries. As a conclusion, positive results concerning patients' knowledge could be achieved with the Internet-based education. The Internet is a viable method in ambulatory care.

  13. Biodegradable injectable polyurethanes: synthesis and evaluation for orthopaedic applications. (United States)

    Adhikari, Raju; Gunatillake, Pathiraja A; Griffiths, Ian; Tatai, Lisa; Wickramaratna, Malsha; Houshyar, Shadi; Moore, Tim; Mayadunne, Roshan T M; Field, John; McGee, Margaret; Carbone, Tania


    Biodegradable polyurethanes offer advantages in the design of injectable or preformed scaffolds for tissue engineering and other medical implant applications. We have developed two-part injectable prepolymer systems (prepolymer A and B) consisting of lactic acid and glycolic acid based polyester star polyols, pentaerythritol (PE) and ethyl lysine diisocyanate (ELDI). This study reports on the formulation and properties of a series of cross linked polyurethanes specifically developed for orthopaedic applications. Prepolymer A was based on PE and ELDI. Polyester polyols (prepolymer B) were based on PE and dl-lactic acid (PEDLLA) or PE and glycolic acid (PEGA) with molecular weights 456 and 453, respectively. Several cross linked porous and non-porous polyurethanes were prepared by mixing and curing prepolymers A and B and their mechanical and thermal properties, in vitro (PBS/37 degrees C/pH 7.4) and in vivo (sheep bi-lateral) degradation evaluated. The effect of incorporating beta-tricalcium phosphate (beta-TCP, 5 microns, 10 wt.%) was also investigated. The cured polymers exhibited high compressive strength (100-190 MPa) and modulus (1600-2300 MPa). beta-TCP improved mechanical properties in PEDLLA based polyurethanes and retarded the onset of in vitro and in vivo degradation. Sheep study results demonstrated that the polymers in both injectable and precured forms did not cause any surgical difficulties or any adverse tissue response. Evidence of new bone growth and the gradual degradation of the polymers were observed with increased implant time up to 6 months.

  14. Statistical sampling and hypothesis testing in orthopaedic research. (United States)

    Bernstein, Joseph; McGuire, Kevin; Freedman, Kevin B


    The purpose of the current article was to review the process of hypothesis testing and statistical sampling and empower readers to critically appraise the literature. When the p value of a study lies above the alpha threshold, the results are said to be not statistically significant. It is possible, however, that real differences do exist, but the study was insufficiently powerful to detect them. In that case, the conclusion that two groups are equivalent is wrong. The probability of this mistake, the Type II error, is given by the beta statistic. The complement of beta, or 1-beta, representing the chance of avoiding a Type II error, is termed the statistical power of the study. We previously examined the statistical power and sample size in all of the studies published in 1997 in the American and British volumes of the Journal of Bone and Joint Surgery, and in Clinical Orthopaedics and Related Research. In the journals examined, only 3% of studies had adequate statistical power to detect a small effect size in this sample. In addition, a study examining only randomized control trials in these journals showed that none of 25 randomized control trials had adequate statistical power to detect a small effect size. However, beta, or power, is less well understood. Because of this, researchers and readers should be aware of the need to address issues of statistical power before a study begins and be cautious of studies that conclude that no difference exists between groups.

  15. Nanostructured glass–ceramic coatings for orthopaedic applications (United States)

    Wang, Guocheng; Lu, Zufu; Liu, Xuanyong; Zhou, Xiaming; Ding, Chuanxian; Zreiqat, Hala


    Glass–ceramics have attracted much attention in the biomedical field, as they provide great possibilities to manipulate their properties by post-treatments, including strength, degradation rate and coefficient of thermal expansion. In this work, hardystonite (HT; Ca2ZnSi2O7) and sphene (SP; CaTiSiO5) glass–ceramic coatings with nanostructures were prepared by a plasma spray technique using conventional powders. The bonding strength and Vickers hardness for HT and SP coatings are higher than the reported values for plasma-sprayed hydroxyapatite coatings. Both types of coatings release bioactive calcium (Ca) and silicon (Si) ions into the surrounding environment. Mineralization test in cell-free culture medium showed that many mushroom-like Ca and phosphorus compounds formed on the HT coatings after 5 h, suggesting its high acellular mineralization ability. Primary human osteoblasts attach, spread and proliferate well on both types of coatings. Higher proliferation rate was observed on the HT coatings compared with the SP coatings and uncoated Ti-6Al-4V alloy, probably due to the zinc ions released from the HT coatings. Higher expression levels of Runx2, osteopontin and type I collagen were observed on both types of coatings compared with Ti-6Al-4V alloy, possibly due to the Ca and Si released from the coatings. Results of this study point to the potential use of HT and SP coatings for orthopaedic applications. PMID:21292725

  16. Use of EO-1 Hyperion data to calculate spectral band adjustment factors (SBAF) between the L7 ETM+ and Terra MODIS sensors (United States)

    Chander, Gyanesh; Mishra, N.; Helder, Dennis L.; Aaron, David; Choi, T.; Angal, A.; Xiong, X.


    Different applications and technology developments in Earth observations necessarily require different spectral coverage. Thus, even for the spectral bands designed to look at the same region of the electromagnetic spectrum, the relative spectral responses (RSR) of different sensors may be different. In this study, spectral band adjustment factors (SBAF) are derived using hyperspectral Earth Observing-1 (EO-1) Hyperion measurements to adjust for the spectral band differences between the Landsat 7 (L7) Enhanced Thematic Mapper Plus (ETM+) and the Terra Moderate Resolution Imaging Spectroradiometer (MODIS) top-of-atmosphere (TOA) reflectance measurements from 2000 to 2009 over the pseudo-invariant Libya 4 reference standard test site.

  17. Search and Retrieval Index to EOS/ESD Symposium Proceedings - 1979 to 1984. (United States)



  18. Measuring the EOS of a Dense, Strongly Coupled Plasma; Description of the Technique

    International Nuclear Information System (INIS)

    Benage, John F. Jr.; Kyraka, George; Workman, Jonathan; Tierney, Thomas


    This paper describes a new experimental design which we believe can produce reasonably accurate data for the equation of state (EOS) of a dense plasma. This design takes advantage of the standard shock technique used for determining the high pressure EOS of solids. It also utilizes recently developed experimental techniques for producing dense, strongly coupled plasmas as well as new diagnostic techniques for measuring the properties of these plasmas. The results should be able to distinguish among theoretical models for plasmas at just under solid density and temperatures of 10's of eV

  19. EOS3nn: An iTOUGH2 module for non-Newtonian liquid and gasflow

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Yu-Shu; Finsterle, Stefan; Pruess, Karsten


    This report documents the iTOUGH2 module EOS3nn, developed for modeling two-phase isothermal flow of a non-Newtonian liquid and a non-condensible gas in multidimensional, porous and fractured geologic media. This document supplements the TOUGH2 and iTOUGH2 user s guides and is therefore not a self-contained manual. It presents information on the physical processes modeled and the mathematical and numerical methods used. Also included are two sample problems for code testing and benchmarking. Modeling scenarios and approaches are discussed to illustrate problem setup and usage of the EOS3nn module.

  20. Utilizing NASA EOS to Assist in Determining Suitable Planting Locations for Bottomland Hardwood Trees in St. Bernard Parish, Louisiana (United States)

    Reahard, R. R.; Arguelles, M.; Ewing, M.; Kelly, C.; Strong, E.


    St. Bernard Parish, located in southeast Louisiana, is rapidly losing coastal forests and wetlands due to a variety of natural and anthropogenic disturbances (e.g. subsidence, saltwater intrusion, low sedimentation, nutrient deficiency, herbivory, canal dredging, levee construction, spread of invasive species, etc.). After Hurricane Katrina severely impacted the area in 2005, multiple Non-Governmental Organizations (NGOs) have focused not only on rebuilding destroyed dwellings, but on rebuilding the ecosystems that once protected the citizens of St. Bernard Parish. Volunteer groups, NGOs, and government entities often work separately and independently of each other and use different sets of information to choose the best planting sites for restoring coastal forests. Using NASA Earth Observing Systems (EOS), Natural Resource Conservation Service (NRCS) soil surveys, and ancillary road and canal data in conjunction with ground truthing, the team created maps of optimal planting sites for several species of bottomland hardwood trees to aid in unifying these organizations, who share a common goal, under one plan. The methodology for this project created a comprehensive Geographic Information System (GIS) to help identify suitable planting sites in St. Bernard Parish. This included supplementing existing elevation data using Digital Elevation Models derived from LIDAR data, and determining existing land cover in the study area from classified Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) imagery. Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) data from a single low-altitude swath was used to assess the health of vegetation over an area near the Mississippi River Gulf Outlet Canal (MRGO) and Bayou La Loutre. Historic extent of coastal forests was also mapped using aerial photos collected between 1952 and 1956. The final products demonstrated yet another application of NASA EOS in the rebuilding and monitoring of coastal ecosystems in

  1. Evaluating the outcomes of a podiatry-led assessment service in a public hospital orthopaedic unit. (United States)

    Bonanno, Daniel R; Medica, Virginia G; Tan, Daphne S; Spring, Anita A; Bird, Adam R; Gazarek, Jana


    In Australia, the demand for foot and ankle orthopaedic services in public health settings currently outweighs capacity. Introducing experienced allied health professionals into orthopaedic units to initiate the triage, assessment and management of patients has been proposed to help meet demand. The aim of this study was to evaluate the effect of introducing a podiatry-led assessment service in a public hospital orthopaedic unit. The outcomes of interest were determining: the proportion of patients discharged without requiring an orthopaedic appointment, agreement in diagnosis between the patient referral and the assessing podiatrist, the proportion of foot and ankle conditions presenting to the service, and the proportion of each condition to require an orthopaedic appointment. This study audited the first 100 patients to receive an appointment at a new podiatry-led assessment service. The podiatrist triaged 'Category 3' referrals consisting of musculoskeletal foot and ankle conditions and appointments were provided for those considered likely to benefit from non-surgical management. Following assessment, patients were referred to an appropriate healthcare professional or were discharged. At the initial appointment or following a period of care, patients were discharged if non-surgical management was successful, surgery was not indicated, patients did not want surgery, and if patient's failed to attend their appointments. All other patients were referred for an orthopaedic consultation as indicated. Ninety-five of the 100 patients (69 females and 31 males; mean age 51.9, SD 16.4 years) attended their appointment at the podiatry-led assessment service. The 95 referrals contained a total of 107 diagnoses, of which the podiatrist agreed with the diagnosis stated on the referral in 56 cases (Kappa =0.49, SE = 0.05). Overall, 34 of the 100 patients were referred to an orthopaedic surgeon and the remaining 66 patients were discharged from the orthopaedic waiting

  2. Importance of patient-centred signage and navigation guide in an orthopaedic and plastics clinic. (United States)

    Maqbool, Talha; Raju, Sneha; In, Eunji


    Gulshan & Nanji Orthopaedic and Plastics Center at the North York General Hospital is the second busiest site after the emergency department serving more than 26,000 patients annually. Increase in patient flow, overworked staff, and recent renovations to the hospital have resulted in patients experiencing long wait times, and thusly patient dissatisfaction and stress. Several factors contribute to patient dissatisfaction and stress: i) poor and unfriendly signage; ii) inconsistent utilization of the numbering system; and iii) difficulty navigating to and from the imaging center. A multidisciplinary QI team was assembled to improve the patient experience. We developed a questionnaire to assess patient stress levels at the baseline. Overall, more than half of the patients (54.8%) strongly agreed or agreed to having a stressful waiting experience. Subsequently, based on patient feedback and staff perspectives, we implemented two PDSA cycles. For PDSA 1, we placed a floor graphic (i.e. black tape) to assist patients in navigating from the clinic to the imaging centre and back. For PDSA 2, we involved creating a single 21"×32" patient-friendly sign at the entrance to welcome patients, with clear instructions outlining registration procedures. Surveys were re-administered to assess patient stress levels. A combination of both interventions caused a statistically significant reduction in patient stress levels based on the Kruskal-Wallis and Mann-Whitney U Tests. The present project highlighted the importance of involving stakeholders as well as frontline staff when undertaking quality improvement projects as a way to identify bottlenecks as well as establish sustainable solutions. Additionally, the team recognized the importance of incorporating empirical based solutions and involving experts in the field to optimize results. The present project successfully implemented strategies to improve patient satisfaction and reduce stress in a high flow community clinic. These

  3. Preliminary experience with SpineEOS, a new software for 3D planning in AIS surgery. (United States)

    Ferrero, Emmanuelle; Mazda, Keyvan; Simon, Anne-Laure; Ilharreborde, Brice


    Preoperative planning of scoliosis surgery is essential in the effective treatment of spine pathology. Thus, precontoured rods have been recently developed to avoid iatrogenic sagittal misalignment and rod breakage. Some specific issues exist in adolescent idiopathic scoliosis (AIS), such as a less distal lower instrumented level, a great variability in the location of inflection point (transition from lumbar lordosis to thoracic kyphosis), and sagittal correction is limited by both bone-implant interface. Since 2007, stereoradiographic imaging system is used and allows for 3D reconstructions. Therefore, a software was developed to perform preoperative 3D surgical planning and to provide rod's shape and length. The goal of this preliminary study was to assess the feasibility, reliability, and the clinical relevance of this new software. Retrospective study on 47 AIS patients operated with the same surgical technique: posteromedial translation through posterior approach with lumbar screws and thoracic sublaminar bands. Pre- and postoperatively, 3D reconstructions were performed on stereoradiographic images (EOS system, Paris, France) and compared. Then, the software was used to plan the surgical correction and determine rod's shape and length. Simulated spine and rods were compared to postoperative real 3D reconstructions. 3D reconstructions and planning were performed by an independent observer. 3D simulations were performed on the 47 patients. No difference was found between the simulated model and the postoperative 3D reconstructions in terms of sagittal parameters. Postoperatively, 21% of LL were not within reference values. Postoperative SVA was 20 mm anterior in 2/3 of the cases. Postoperative rods were significantly longer than precontoured rods planned with the software (mean 10 mm). Inflection points were different on the rods used and the planned rods (2.3 levels on average). In this preliminary study, the software based on 3D stereoradiography low

  4. Low-Mass Planar Photonic Imaging Sensor Project (United States)

    National Aeronautics and Space Administration — We propose a revolutionary electro-optical (EO) imaging sensor concept that provides a low-mass, low-volume alternative to the traditional bulky optical telescope...

  5. Multi-angle Imaging SpectroRadiometer (MISR) (United States)

    National Aeronautics and Space Administration — The Multi-angle Imaging SpectroRadiometer (MISR) was successfully launched into sun-synchronous polar orbit aboard Terra, NASA's first Earth Observing System (EOS)...

  6. Electro-Optic Imaging Fourier Transform Spectral Polarimeter, Phase I (United States)

    National Aeronautics and Space Administration — Boulder Nonlinear Systems, Inc. (BNS) proposes to develop an Electro-Optic Imaging Fourier Transform Spectral Polarimeter (E-O IFTSP). The polarimetric system is...

  7. A Reference Implementation of the OGC CSW EO Standard for the ESA HMA-T project (United States)

    Bigagli, Lorenzo; Boldrini, Enrico; Papeschi, Fabrizio; Vitale, Fabrizio


    This work was developed in the context of the ESA Heterogeneous Missions Accessibility (HMA) project, whose main objective is to involve the stakeholders, namely National space agencies, satellite or mission owners and operators, in an harmonization and standardization process of their ground segment services and related interfaces. Among HMA objectives was the specification, conformance testing, and experimentation of two Extension Packages (EPs) of the ebRIM Application Profile (AP) of the OGC Catalog Service for the Web (CSW) specification: the Earth Observation Products (EO) EP (OGC 06-131) and the Cataloguing of ISO Metadata (CIM) EP (OGC 07-038). Our contributions have included the development and deployment of Reference Implementations (RIs) for both the above specifications, and their integration with the ESA Service Support Environment (SSE). The RIs are based on the GI-cat framework, an implementation of a distributed catalog service, able to query disparate Earth and Space Science data sources (e.g. OGC Web Services, Unidata THREDDS) and to expose several standard interfaces for data discovery (e.g. OGC CSW ISO AP). Following our initial planning, the GI-cat framework has been extended in order to expose the CSW.ebRIM-CIM and CSW.ebRIM-EO interfaces, and to distribute queries to CSW.ebRIM-CIM and CSW.ebRIM-EO data sources. We expected that a mapping strategy would suffice for accommodating CIM, but this proved to be unpractical during implementation. Hence, a model extension strategy was eventually implemented for both the CIM and EO EPs, and the GI-cat federal model was enhanced in order to support the underlying ebRIM AP. This work has provided us with new insights into the different data models for geospatial data, and the technologies for their implementation. The extension is used by suitable CIM and EO profilers (front-end mediator components) and accessors (back-end mediator components), that relate ISO 19115 concepts to EO and CIM ones. Moreover

  8. Trend report Energy Research Subsidy programme (2005-2008). A report on the most important trends and effects since the start of the Energy Research Subsidy (EOS) programme

    International Nuclear Information System (INIS)

    Kimman, J.; Soeriowardojo, E.; Witte, F.; Nijdam, J.


    In 2005 the Energy Research Subsidy programme (EOS) was launched in the Netherlands. In four years' time about 500 projects were realized thanks to contributions from EOS. This report provides an overview of the main trends and effects of EOS in the period 2005-2008. One of the main conclusions is that a number of technologies have developed from invention level to market-ready level thanks to the EOS programme. The main trends since the start of EOS are: Increasing confidence of investors in EOS spearheads; increasing activity in EOS spearheads; Spearheads shifting to investment and exploitation schemes; EOS contributes to a solid patent position of Dutch parties; EOS contributes to European research. [nl

  9. Comparative anticonvulsant activities of the essential oils (EOs) from Cymbopogon winterianus Jowitt and Cymbopogon citratus (DC) Stapf. in mice. (United States)

    Silva, Monalisa Ribeiro; Ximenes, Rafael Matos; da Costa, José Galberto Martins; Leal, L Kalyne A M; de Lopes, Amanda A; Viana, Glauce Socorro de Barros


    The fresh leaves of Cymbopogon citratus are a good source of an essential oil (EO) rich in citral, and its tea is largely used in the Brazilian folk medicine as a sedative. A similar source of EO is Cymbopogon winterianus, rich in citronellal. The literature presents more studies on the EO of C. citratus and their isolated bioactive components, but only a few are found on the EO of C. winterianus. The objective of the present study was then to study, in a comparative way, the effects of both EOs on three models of convulsions (pentylenetetrazol, pilocarpine, and strychnine) and on the barbiturate-induced sleeping time on male Swiss mice. The animals (20-30 g) were acutely treated with 50, 100, and 200 mg kg(-1), intraperitoneally, of each EO, and 30 min later, the test was initiated. The observed parameters were: latency to the first convulsion and latency to death in seconds. Furthermore, the in vitro effects of the EOs were also studied on myeloperoxidase (MPO; a biomarker for inflammation) and lactate dehydrogenase (LDH; an index of cytotoxicity) releases from human neutrophils. The EOs radical-scavenging activities were also evaluated by the 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay. The results showed that both EOs were more active on the pentylenetetrazol-induced convulsion model, and C. citratus was even more efficient in increasing latency to the first convulsion and latency to death. Both parameters were potentiated in the presence of a lower dose of diazepam (reference drug) when associated to a lower dose of each EO (25 mg kg(-1)). Besides, their anticonvulsant effects were blocked by flumazenil, a known benzodiazepine antagonist. This effect was somewhat lower on the pilocarpine-induced convulsion, and better effects were seen only with the EOs' higher doses (200 mg kg(-1)). A similar result was observed on the strychnine-induced convulsion model. Both EOs potentiated the barbiturate-induced sleeping time. However, C. citratus was more efficient

  10. Pediatric Orthopaedic Workforce in 2014: Current Workforce and Projections for the Future. (United States)

    Sawyer, Jeffrey R; Jones, Kerwyn C; Copley, Lawson A; Chambers, Stephanie


    The changing nature of the United States (US) health care system has prompted debate concerning the physician supply. The basic questions are: do we have an adequate number of surgeons to meet current demands and are we training the correct number of surgeons to meet future demands? The purpose of this analysis was to characterize the current pediatric orthopaedic workforce in terms of supply and demand, both present and future. Databases were searched (POSNA, SF Match, KID, MGMA) to determine the current pediatric orthopaedic workforce and workforce distribution, as well as pediatric orthopaedic demand. The number of active Pediatric Orthopaedic Society of North America (POSNA) members increased over the past 20 years, from 410 in 1993 to 653 in 2014 (155% increase); however, the density of POSNA members is not equally distributed, but correlates to population density. The number of estimated pediatric discharges, orthopaedic and nonorthopaedic, has remained relatively stable from 6,348,537 in 1997 to 5,850,184 in 2012. Between 2003 and 2013, the number of pediatric orthopaedic fellows graduating from Accreditation Council for Graduate Medical Education and non-Accreditation Council for Graduate Medical Education programs increased from 39 to 50 (29%), with a peak of 67 fellows (71%) in 2009. Although predicting the exact need for pediatric orthopaedic surgeons (POS) is impossible because of the complex interplay among macroeconomic, governmental, insurance, and local factors, some trends were identified: the supply of POS has increased, which may offset the expected numbers of experienced surgeons who will be leaving the workforce in the next 10 to 15 years; macroeconomic factors influencing demand for physician services, driven by gross domestic product and population growth, are expected to be stable in the near future; expansion of the scope of practice for POS is expected to continue; and further similar assessments are warranted. Level II-economic and

  11. Etiology of Readmissions Following Orthopaedic Procedures and Medical Admissions. A Comparative Analysis. (United States)

    Maslow, Jed; Hutzler, Lorraine; Slover, James; Bosco, Joseph


    The Federal Government, the largest payer of health care, considers readmission within 30 days of discharge an indicator of quality of care. Many studies have focused on causes for and strategies to reduce readmissions following medical admissions. However, few studies have focused on the differences between them. We believe that the causes for readmission following orthopaedic surgery are markedly different than those following medical admissions, and therefore, the strategies developed to reduce medical readmissions will not be as effective in reducing readmissions after elective orthopaedic surgery. All unplanned 30-day readmissions following an index hospitalization for an elective orthopaedic procedure (primary and revision total joint arthroplasty and spine procedure) or for one of the three publicly reported medical conditions (AMI, HF, and pneumonia, which accounted for 11% of readmissions) were identified at our institution from 2010 through 2012. A total of 268 patients and 390 medical patients were identified as having an unplanned 30-day readmission. We reviewed a prospectively collected data base to determine the reason for readmission in each encounter. A total of 233 (86.9%) orthopaedic patients were readmitted for surgical complications, most commonly for a wound infection (56.0%) or wound complication (11.6%). Following an index admission of HF or AMI, the primary reason for readmission was a disease of the circulatory system (55.9% and 57.4%, respectively). Following an index admission for pneumonia, the primary reason for readmission was a disease of the respiratory system (34.5%). The causes of readmissions following orthopaedic surgery and medical admissions are different. Patients undergoing orthopaedic procedures are readmitted for surgical complications, frequently unrelated to aftercare, and medicine patients are readmitted for reasons related to the index diagnosis. Interventions designed to reduce orthopaedic readmissions must focus on

  12. Barriers and Facilitators Associated with Non-Surgical Treatment Use for Osteoarthritis Patients in Orthopaedic Practice.

    Directory of Open Access Journals (Sweden)

    Stefanie N Hofstede

    Full Text Available International evidence-based guidelines for the management of patients with hip and knee osteoarthritis (OA recommend to start with (a combination of non-surgical treatments, and using surgical intervention only if a patient does not respond sufficiently to non-surgical treatment options. Despite these recommendations, there are strong indications that non-surgical treatments are not optimally used in orthopaedic practice. To improve the adoption of non-surgical treatments, more insight is needed into barriers and facilitators of these treatments. Therefore, this study assessed which barriers and facilitators are associated with the use and prescription of different non-surgical treatments before hip and knee OA in orthopaedic practice among patients and orthopaedic surgeons in the Netherlands.We performed two internet-based surveys among 172 orthopaedic surgeons and 174 OA patients. Univariate association and multivariable regression techniques are used to identify barriers and facilitators associated with the use of non-surgical treatments.Most barriers and facilitators among patients were associated with the use of physical therapy, lifestyle advice and dietary therapy. Among orthopaedic surgeons, most were associated with prescription of acetaminophen, dietary therapy and physical therapy. Examples of barriers and facilitators among patients included "People in my environment had positive experiences with a surgery" (facilitator for education about OA, and "Advice of people in my environment to keep on moving" (facilitator for lifestyle and dietary advice. For orthopaedic surgeons, examples were "Lack of knowledge about guideline" (barrier for lifestyle advice, "Agreements/ deliberations with primary care" and "Easy communication with a dietician" (facilitators for dietary therapy. Also the belief in the efficacy of these treatments was associated with increased prescription.Strategies to improve non-surgical treatment use in orthopaedic

  13. Orthodontic and orthopaedic treatment for anterior open bite in children. (United States)

    Lentini-Oliveira, Débora A; Carvalho, Fernando R; Rodrigues, Clarissa Garcia; Ye, Qingsong; Prado, Lucila B F; Prado, Gilmar F; Hu, Rongdang


    Anterior open bite occurs when there is a lack of vertical overlap of the upper and lower incisors. The aetiology is multifactorial including: oral habits, unfavourable growth patterns, enlarged lymphatic tissue with mouth breathing. Several treatments have been proposed to correct this malocclusion, but interventions are not supported by strong scientific evidence. The aim of this systematic review was to evaluate orthodontic and orthopaedic treatments to correct anterior open bite in children. The following databases were searched: the Cochrane Oral Health Group's Trials Register (to 14 February 2014); the Cochrane Central Register of Controlled Trials (CENTRAL)(The Cochrane Library 2014, Issue 1); MEDLINE via OVID (1946 to 14 February 2014); EMBASE via OVID (1980 to 14 February 2014); LILACS via BIREME Virtual Health Library (1982 to 14 February 2014); BBO via BIREME Virtual Health Library (1980 to 14 February 2014); and SciELO (1997 to 14 February 2014). We searched for ongoing trials via (to 14 February 2014). Chinese journals were handsearched and the bibliographies of papers were retrieved. All randomised or quasi-randomised controlled trials of orthodontic or orthopaedic treatments or both to correct anterior open bite in children. Two review authors independently assessed the eligibility of all reports identified. Risk ratios (RRs) and corresponding 95% confidence intervals (CIs) were calculated for dichotomous data. The continuous data were expressed as described by the author. Three randomised controlled trials were included comparing: effects of Frankel's function regulator-4 (FR-4) with lip-seal training versus no treatment; repelling-magnet splints versus bite-blocks; and palatal crib associated with high-pull chincup versus no treatment.The study comparing repelling-magnet splints versus bite-blocks could not be analysed because the authors interrupted the treatment earlier than planned due to side effects in four of ten patients

  14. Development of Bioresorbable Fe-Mn Alloys for Orthopaedic Implantation (United States)

    Heiden, Michael

    Degradable, transient orthopaedic implants have been proposed for years, with the aim to replace permanent biomaterials that are left in the body indefinitely or that have to be removed via surgical procedures. Current resorbable implant designs either degrade too quickly, injuring surrounding tissue while losing necessary mechanical strength before full tissue reconstruction, or degrade too slowly, thereby acting like a permanent implant. Permanent fracture fixation devices in particular have the potential to lead to failures in the long-term, systemic tissue toxicity, and overall discomfort for the patients. The next generation of biomaterials that resorb away after supporting full tissue reconstruction are desired in order to mitigate these problems. In order to address past complications in design of clinically viable degradable orthopaedic implants, an extensive range of material selection and processing techniques are investigated. The degradation kinetics of Fe-Mn alloys are assessed using a combination of electrochemical polarization and in vitro mass loss experiments. Additionally, the mechanisms behind the surface morphological evolution while subject to prolonged immersion in simulated body fluid are investigated in detail. An unstable iron-rich oxide layer was observed to form immediately upon immersion, which diminishes further degradation. Microstructural and effective strain effects are explored using a severe plastic deformation technique called large-strain machining (LSM), along with cold-rolling, and annealing treatments. It was discovered that LSM of Fe-33Mn with a rake angle of 0° generated 16 microm thin, dendritic band-like structures, which contributed to a 140% increase in the degradation rate compared to cast structures of the same alloy. There was no major correlation between effective strain imparted into the material and the degradation rate, but decreasing grain size did increase corrosion susceptibility up to a point. Thus, it

  15. Peer-assisted learning and orthopaedic evaluation psychomotor skills. (United States)

    Weidner, Thomas G; Popp, Jennifer K


    Athletic training educators often anecdotally suggest that athletic training students enhance their learning by teaching their peers. However, peer-assisted learning (PAL) has not been examined within athletic training education to provide evidence for PAL's current use or for its use as a pedagogic tool. To assess the effectiveness of intentional, formal PAL on the performance of psychomotor skills and to identify students' perceptions of PAL. Randomized, pretest-posttest experimental design. Athletic Training Research and Education Laboratory. Fifty-one undergraduate students (27 athletic training majors, 24 nonmajors). Review sessions led by either an Approved Clinical Instructor or peer tutor. We assessed pretest and posttest performance scores (number of correct skills) and the amount of time to complete the psychomotor skills in 3 categories of orthopaedic evaluation of the hand and wrist for subjects assigned to either a peer tutor or an Approved Clinical Instructor review group. Using the Athletic Training Peer-Assisted Learning Assessment Survey, we evaluated the perceptions of students assigned to the peer-tutor group regarding the benefits of, and preferences for, PAL. Differences in the pretest-posttest skill scores were noted in both groups (P psychomotor skills with peer tutors than with the laboratory instructor, and many students (n = 12, 44.4%) felt more self-confident when practicing psychomotor skills with a peer tutor. Peer-assisted learning appears to be a valid method for improving athletic training psychomotor skills. Peers can be resources for practicing clinical skills and report benefiting from the collaboration. Peer-assisted learning should be deliberately integrated into athletic training education programs to enhance student learning and collaboration.

  16. Low-income countries' orthopaedic information needs: challenges and opportunities. (United States)

    Doughty, Kathryn; Rothman, Linda; Johnston, Luke; Le, Kim; Wu, Joanna; Howard, Andrew


    The Internet should, in theory, facilitate access to peer-reviewed scientific articles for orthopaedic surgeons in low-income countries (LIC). However, there are major barriers to access, and most full-text journal articles are available only on a subscription basis, which many in LIC cannot afford. Various models exist to remove such barriers. We set out to examine the potential, and reality, of journal article access for surgeons in LIC by studying readership patterns and journal access through a number of Internet-based initiatives, including an open access journal ("PLoS Medicine"), and programs from the University of Toronto (The Ptolemy Project) and World Health Organization (WHO) (Health InterNetwork Access to Research Initiative [HINARI]). Do Internet-based initiatives that focus on peer-reviewed journal articles deliver clinically relevant information to those who need it? More specifically: (1) Can the WHO's program meet the information needs of practicing surgeons in Africa? (2) Are healthcare workers across the globe aware of, and using, open access journals in a manner that reflects global burden of disease (GBD)? We compared actual Ptolemy use to HINARI holdings. We also compared "PLoS Medicine" readership patterns among low-, middle-, and high-income regions. Many of the electronic resources used through Ptolemy are not available through HINARI. In contrast to higher-income regions, "PLoS Medicine" readership in Africa is proportional to both the density of healthcare workers and the GBD there. Free or low-cost Internet-based initiatives can improve access to the medical literature in LIC. Open access journals are a key component to providing clinically relevant literature to the regions and healthcare workers who need it most.

  17. Imaging of Periprosthetic Infection.

    LENUS (Irish Health Repository)

    Carty, Fiona


    Periprosthetic infection is one of the most challenging and difficult complications in orthopaedics. It can result in significant patient distress and disability, with repeated surgeries, increased cost and utilization of medical resources, and in rare cases even mortality. The biggest challenge to date is the correct diagnosis of periprosthetic infection and implementation of effective treatment regimens capable of eradicating the organism. This article reviews the various modalities used in the imaging of periprosthetic and post-arthroplasty infection.

  18. Mission Status for Earth Science Constellation MOWG Meeting at KSC: EOS Aura (United States)

    Fisher, Dominic


    This will be presented at the Earth Science Constellation Mission Operations Working Group (MOWG) meeting at KSC (Kennedy Space Center) in December 2017 to discus EOS (Earth Observing System) Aura status. Reviewed and approved by Eric Moyer, ESMO (Earth Sciences Mission Operations) Deputy Project Manager.


    Directory of Open Access Journals (Sweden)

    F. Marcondes


    Full Text Available Abstract In the past thirty years, the development of compositional reservoir simulators using an equation of state (EOS has been addressed in the literature. However, the development of compositional thermal simulators in conjunction with the EOS formulation, in particular, has not been addressed extensively. In this work, a fully implicit, thermal, compositional EOS-based simulator in conjunction with unstructured meshes has been developed. In this model, an equation of state is used for equilibrium calculations among phases. Also, the physical properties are calculated based on an EOS, hence obviating the need for using steam tables for calculation of water/steam properties. The governing equations for the model comprise fugacity equations, material balance, pore volume constraint and energy equation. The governing partial differential equations are solved using the EbFVM (Element based Finite Volume Method. Results for several case studies consisting of 2D and 3D reservoirs are presented in order to demonstrate the applicability of the method.

  20. Heavy ion reaction measurements with the EOS TPC (looking for central collisions with missing energy)

    International Nuclear Information System (INIS)

    Wieman, H.H.


    The EOS TPC was constructed for complete event measurement of heavy ion collisions at the Bevalac. We report here on the TPC design and some preliminary measurements of conserved event quantities such as total invariant mass, total momentum, total A and Z

  1. Language Attitudes of Asturian Students in the Area of Navia-Eo (Spain) (United States)

    González-Riaño, Xosé; Hevia-Artime, Isabel; Fernández-Costales, Alberto


    This paper presents a synthesis of a pioneering study that approaches the sociolinguistic and educational reality of the area of Navia-Eo, a region in the western part of Asturias (Spain). This research aims to provide an insight into the language attitudes and the sociolinguistic awareness of students in the final year of primary education. Using…

  2. Prediction of detonation and JWL eos parameters of energetic materials using EXPLO5 computer code

    CSIR Research Space (South Africa)

    Peter, Xolani


    Full Text Available that the users can choose between the explosive types of constants in the BKW-EOS. The code calculates the parameters of state of the products along the shock adiabate, starting from a density of a given unreacted explosive (sub po) and then increasing...

  3. Bone mineral density assessment using the EOS low-dose X-ray device: a feasibility study. (United States)

    Sapin, E; Briot, K; Kolta, S; Gravel, P; Skalli, W; Roux, C; Mitton, D


    To predict bone strength in the case of osteoporosis, it could be a real benefit to assess the three-dimensional (3D) geometry and the bone mineral density (BMD) with a single low-dose X-ray device, such as the EOS system (Biospace Med, Paris, France). EOS 3D reconstructions of the spine have already been validated. Thus, this study aims at evaluating the accuracy of this low-dose system as a densitometer first ex vivo. The European Spine Phantom (ESP) (number 129) was scanned ten times using both the EOS and a Hologic device (Hologic, Inc., Massachusetts, USA). Accuracy was given by the sum of the systematic error (difference between BMDs assessed and true values given by the phantom manufacturer) and the random error (coefficient of variation). EOS BMDs and Hologic BMDs of 41 ex-vivo vertebrae were calculated and compared. The reproducibility of the method evaluating the EOS BMD was assessed giving the coefficient of variation of three measurements of the 41 vertebrae. The accuracy of the EOS system is below 5.2 per cent, versus 7.2 per cent for the Hologic system in the same conditions. EOS BMDs are significantly higher than Hologic BMDs, but they are strongly correlated. The reproducibility of the method of assessment is equal to 0.95 per cent. The EOS system is accurate for ex-vivo BMD assessments, which is promising regarding the use of this new system to predict vertebral strength.

  4. Accredited Orthopaedic Sports Medicine Fellowship Websites: An Updated Assessment of Accessibility and Content. (United States)

    Yayac, Michael; Javandal, Mitra; Mulcahey, Mary K


    A substantial number of orthopaedic surgeons apply for sports medicine fellowships after residency completion. The Internet is one of the most important resources applicants use to obtain information about fellowship programs, with the program website serving as one of the most influential sources. The American Orthopaedic Society for Sports Medicine (AOSSM), San Francisco Match (SFM), and Arthroscopy Association of North America (AANA) maintain databases of orthopaedic sports medicine fellowship programs. A 2013 study evaluated the content and accessibility of the websites for accredited orthopaedic sports medicine fellowships. To reassess these websites based on the same parameters and compare the results with those of the study published in 2013 to determine whether any improvement has been made in fellowship website content or accessibility. Cross-sectional study. We reviewed all existing websites for the 95 accredited orthopaedic sports medicine fellowships included in the AOSSM, SFM, and AANA databases. Accessibility of the websites was determined by performing a Google search for each program. A total of 89 sports fellowship websites were evaluated for overall content. Websites for the remaining 6 programs could not be identified, so they were not included in content assessment. Of the 95 accredited sports medicine fellowships, 49 (52%) provided links in the AOSSM database, 89 (94%) in the SFM database, and 24 (25%) in the AANA database. Of the 89 websites, 89 (100%) provided a description of the program, 62 (70%) provided selection process information, and 40 (45%) provided a link to the SFM website. Two searches through Google were able to identify links to 88% and 92% of all accredited programs. The majority of accredited orthopaedic sports medicine fellowship programs fail to utilize the Internet to its full potential as a resource to provide applicants with detailed information about the program, which could help residents in the selection and ranking

  5. Eo-1 Hyperion Measures Canopy Drought Stress In Amazonia (United States)

    Asner, Gregory P.; Nepstad, Daniel; Cardinot, Gina; Moutinho, Paulo; Harris, Thomas; Ray, David


    The central, south and southeast portions of the Amazon Basin experience a period of decreased cloud cover and precipitation from June through November. There are likely important effects of seasonal and interannual rainfall variation on forest leaf area index, canopy water stress, productivity and regional carbon cycling in the Amazon. While both ground and spaceborne studies of precipitation continue to improve, there has been almost no progress made in observing forest canopy responses to rainfall variability in the humid tropics. This shortfall stems from the large stature of the vegetation and great spatial extent of tropical forests, both of which strongly impede field studies of forest responses to water availability. Those few studies employing satellite measures of canopy responses to seasonal and interannual drought (e.g., Bohlman et al. 1998, Asner et al. 2000) have been limited by the spectral resolution and sampling available from Landsat and AVHRR sensors. We report on a study combining the first landscape-level, managed drought experiment in Amazon tropical forest with the first spaceborne imaging spectrometer observations of this experimental area. Using extensive field data on rainfall inputs, soil water content, and both leaf and canopy responses, we test the hypothesis that spectroscopic signatures unique to hyperspectral observations can be used to quantify relative differences in canopy stress resulting from water availability.

  6. A review of virtual reality based training simulators for orthopaedic surgery. (United States)

    Vaughan, Neil; Dubey, Venketesh N; Wainwright, Thomas W; Middleton, Robert G


    This review presents current virtual reality based training simulators for hip, knee and other orthopaedic surgery, including elective and trauma surgical procedures. There have not been any reviews focussing on hip and knee orthopaedic simulators. A comparison of existing simulator features is provided to identify what is missing and what is required to improve upon current simulators. In total 11 hip replacements pre-operative planning tools were analysed, plus 9 hip trauma fracture training simulators. Additionally 9 knee arthroscopy simulators and 8 other orthopaedic simulators were included for comparison. The findings are that for orthopaedic surgery simulators in general, there is increasing use of patient-specific virtual models which reduce the learning curve. Modelling is also being used for patient-specific implant design and manufacture. Simulators are being increasingly validated for assessment as well as training. There are very few training simulators available for hip replacement, yet more advanced virtual reality is being used for other procedures such as hip trauma and drilling. Training simulators for hip replacement and orthopaedic surgery in general lag behind other surgical procedures for which virtual reality has become more common. Further developments are required to bring hip replacement training simulation up to date with other procedures. This suggests there is a gap in the market for a new high fidelity hip replacement and resurfacing training simulator. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

  7. Supply and Demand Analysis of the Orthopaedic Trauma Surgeon Workforce in the United States. (United States)

    Sielatycki, John A; Sawyer, Jeffrey R; Mir, Hassan R


    To investigate recent trends in the orthopaedic trauma workforce and to assess whether supply of orthopaedic trauma surgeons (OTS) matches the demand for their skills. Supply estimated using Orthopaedic Trauma Association (OTA) membership and American Academy of Orthopaedic Surgeons census data. The annual number of operative pelvic and acetabular fractures reported by American College of Surgeons verified trauma centers in the National Trauma Data Bank (NTDB) was used as a surrogate of demand. Because surrogates were used, the annual rate of change in OTA membership versus rate of change in operative injuries per NTDB center was compared. From 2002 to 2012, reported operative pelvic and acetabular injuries increased by an average of 21.0% per year. The number of reporting trauma centers increased by 27.2% per year. The number of OTA members increased each year except in 2009, with mean annual increase of 9.8%. The mean number of orthopaedic surgeons per NTDB center increased from 7.98 to 8.58, an average of 1.5% per year. The annual number of operative pelvic and acetabular fractures per NTDB center decreased from 27.1 in 2002 to 19.03 in 2012, down 2.0% per year. In the United States, from 2002 to 2012, the number of OTS trended upward, whereas operative pelvic and acetabular cases per reporting NTDB center declined. These trends suggest a net loss of such cases per OTS over this period.

  8. Loss of Follow-up in Orthopaedic Trauma: Who Is Getting Lost to Follow-up? (United States)

    Zelle, Boris A; Buttacavoli, Frank A; Shroff, Jeffrey B; Stirton, Jacob B


    Noncompliance with postoperative follow-up visits remains a common problem in orthopaedic trauma. The aim of this study was to identify risk factors for loss of follow-up after orthopaedic trauma. Retrospective review. Urban level 1 academic trauma center. A total of 307 (226 men/81 women) patients undergoing surgical treatment of their orthopaedic injuries were included in this study. The average age was 40.4 ± 17 years. All patients were treated surgically for their orthopaedic injuries and were instructed to follow-up in the orthopaedic trauma clinic after hospital discharge. Noncompliance with follow-up appointment at 6 months after injury. Over a 6-month postoperative period, a total of 215 patients were noncompliant with at least one of their follow-up appointments between hospital discharge and the 6-month follow-up. A logistic regression showed male gender, uninsured or government insurance, and smoker to be statistically significant risk factors for noncompliance with the 6-month follow-up (P trauma. Our study suggests different risk factors for noncompliance, including male gender, smoker, lack of commercial health insurance, and illicit drug abuse. Health care providers may consider establishing protocols for facilitating follow-up appointments to patients who are at risk for noncompliance.

  9. A comparison of airborne bacterial fallout between orthopaedic and vascular surgery. (United States)

    Stather, P; Salji, M; Hassan, S-U; Abbas, M; Ahmed, A; Mills, H; Elston, T; Backhouse, C; Howard, A; Choksy, S


    INTRODUCTION The objective of the study was to compare bacterial fallout during vascular prosthesis insertion and orthopaedic major joint replacement performed in conventional and laminar flow ventilation, respectively. MATERIALS AND METHODS A prospective single-centre case control study of 21 consecutive elective vascular procedures involving prosthetic graft insertion and 24 consecutive elective orthopaedic major joint replacements were tested for degree of bacterial fallout using agar settle plates. Preparation time, waiting time and total procedure duration were collected at the time of surgery, and bacterial colony counts on the agar settle plates from airborne bacterial fallout were counted after an incubation period. RESULTS Bacterial fallout count in vascular prosthetic graft insertion was 15-fold greater than in orthopaedic prosthetic joint insertion (15, (IQR 15) vs 1, (IQR 3) respectively, P fallout counts during the procedure (P = 0.9). CONCLUSIONS Vascular surgical theatres have significantly higher bacterial fallout compared with orthopaedic theatres. This may be partly explained by orthopaedic surgery being routinely performed in laminar flow ventilation, a practice which has not been widely adopted for vascular surgery, in which prosthetic infection may also result in significant mortality and morbidity.

  10. Biodegradable magnesium alloys for orthopaedic applications: A review on corrosion, biocompatibility and surface modifications

    International Nuclear Information System (INIS)

    Agarwal, Sankalp; Curtin, James; Duffy, Brendan; Jaiswal, Swarna


    Magnesium (Mg) and its alloys have been extensively explored as potential biodegradable implant materials for orthopaedic applications (e.g. Fracture fixation). However, the rapid corrosion of Mg based alloys in physiological conditions has delayed their introduction for therapeutic applications to date. The present review focuses on corrosion, biocompatibility and surface modifications of biodegradable Mg alloys for orthopaedic applications. Initially, the corrosion behaviour of Mg alloys and the effect of alloying elements on corrosion and biocompatibility is discussed. Furthermore, the influence of polymeric deposit coatings, namely sol-gel, synthetic aliphatic polyesters and natural polymers on corrosion and biological performance of Mg and its alloy for orthopaedic applications are presented. It was found that inclusion of alloying elements such as Al, Mn, Ca, Zn and rare earth elements provides improved corrosion resistance to Mg alloys. It has been also observed that sol-gel and synthetic aliphatic polyesters based coatings exhibit improved corrosion resistance as compared to natural polymers, which has higher biocompatibility due to their biomimetic nature. It is concluded that, surface modification is a promising approach to improve the performance of Mg-based biomaterials for orthopaedic applications. - Highlights: • The Mg based alloys are promising candidates for orthopaedic applications. • The rapid corrosion of Mg can affect human cells, and causes infection and implant failure. • The various physiological factors and Mg alloying elements affect the corrosion and mechanical properties of implants. • The polymeric deposit coatings enhance the corrosion resistance and biocompatibility.

  11. Improvement of research quality in the fields of orthopaedics and trauma: a global perspective. (United States)

    Fayaz, Hangama C; Haas, Norbert; Kellam, James; Bavonratanavech, Suthorn; Parvizi, Javad; Dyer, George; Pohlemann, Tim; Jerosch, Jörg; Prommersberger, Karl-Josef; Pape, Hans Christoph; Smith, Malcolm; Vrahas, Marc; Perka, Carsten; Siebenrock, Klaus; Elhassan, Bassem; Moran, Christopher; Jupiter, Jesse B


    The international orthopaedic community aims to achieve the best possible outcome for patient care by constantly modifying surgical techniques and expanding the surgeon's knowledge. These efforts require proper reflection within a setting that necessitates a higher quality standard for global orthopaedic publication. Furthermore, these techniques demand that surgeons acquire information at a rapid rate while enforcing higher standards in research performance. An international consensus exists on how to perform research and what rules should be considered when publishing a scientific paper. Despite this global agreement, in today's "Cross Check Era", too many authors do not give attention to the current standards of systematic research. Thus, the purpose of this paper is to describe these performance standards, the available choices for orthopaedic surgeons and the current learning curve for seasoned teams of researchers and orthopaedic surgeons with more than three decades of experience. These lead to provide an accessible overview of all important aspects of the topics that will significantly influence the research development as we arrive at an important globalisation era in orthopaedics and trauma-related research.

  12. 9th Chapter of Surgeons' Lecture: the orthopaedic surgeon: historical perspective, ethical considerations and the future. (United States)

    Balachandran, N


    From a fishing village with colonial surgeons from the East India Company, Singapore is now a medical and business hub servicing the region and beyond in trade and medical education. Orthopaedic Surgery is a young specialty and is the fastest growing sub-specialty in Surgery. Orthopaedic education in Singapore has a structured syllabus and training is coordinated with the Royal Colleges and the American Academy of Orthopaedic Surgeons. Part of the training as Fellows is in the United Kingdom and USA on an HMDP Fellowship. Ethics and Continuing Medical Education need further emphasis. Sub-specialisation in Orthopaedic Surgery is now well-established in Trauma, Adult Reconstructive Surgery, Sports Medicine, Spinal Surgery, Hand Surgery and Rehabilitation Medicine. Ageing in the next millennium with osteoporosis and hip fracture problems of gait and balance need more orthopaedic surgeons to be committed to rehabilitation medicine and voluntary service in the community. There is a need for good role models and knowledge on Quality Assurance, Clinical Pathways and Administration. Appropriate use of high technology and care for the aged in the community with dignity is fundamental to good ethical practice. Selfish, pecuniary interests will destroy the very soul and fabric of medicine.

  13. Prevalence of MRSA colonization in an adult urban Indian population undergoing orthopaedic surgery. (United States)

    Agarwala, Sanjay; Lad, Dnyanesh; Agashe, Vikas; Sobti, Anshul


    Orthopaedic surgery is technically demanding, implant dependant and expensive. Infection translates into a prolonged morbidity and long-term use of antibiotics. The most common organism involved in osteo-articular infections is Staphylococcus aureus, and colonizes the anterior nares of 25-30% of the population. Carriers are at higher risk for staphylococcal infections after invasive medical or surgical procedures. Prevalence of methicillin resistant Staphylococcus aureus (MRSA) has not been assessed in patients admitted for orthopaedic surgery in the Indian setting. To assess the preoperative prevalence of MRSA colonization in adult patients undergoing orthopaedic surgery in urban India. This is a retrospective analysis of patients from 2009 to 2013. A total of 1550 patients admitted for orthopaedic surgery were preoperatively screened with nasal and axillary swabs for MRSA. Swab-positive patients were treated with intranasal mupirocin ointment for 3 days followed by a repeat swab. A record was made of hospitalization in the year prior to surgery and the occurrence of surgical site infection (SSI). A total of 690 males and 860 females had been screened for MRSA using an inexpensive kit costing 500 Indian rupees. For MRSA, 7/1550 (0.45%) nasal swabs were positive. No patient since 2009 has had a SSI with MRSA. MRSA screening prior to orthopaedic surgery is a valuable and cost effective preoperative investigation even though the incidence is low. Mupirocin is effective in clearing MRSA from the nares and maybe used for 3 days to obtain elimination of the bacteria.

  14. Scientific requirements for a Moderate-Resolution Imaging Spectrometer (MODIS) for EOS (United States)

    Barnes, W. L.


    The MODIS is an instrument planned for the sun-synchronous polar orbiting segment of the Space Station system. The radiometer is required to have 1 km resolution in terrestrial remote sensing applications. The monitoring program is targeted to last 10 yr in order to provide a sufficient database for discerning trends as opposed to natural variations. The study areas of interest include tropical deforestation, regrowth and areal distributions, acid rain effects on northern forests, desertification rates and locations, snow cover/albedo relationships and total biomass. MODIS will have 192 channels with 30 m spatial resolution and cover seven bands in the 3.5-12 microns interval for land viewing. Ocean studies will be carried out in 17 bands from 0.4-1.0 micron, and atmospheric scans will be performed over the land and ocean intervals at narrowband wavelengths (1.2 nm). Si detector arrays will be used and will be accompanied by an expected 600:1 SNR and produce data at a rate of 1.4-9.1 Mb/sec.

  15. The first observation of EO transitions from negative parity states in even-even nucleus 160Dy

    International Nuclear Information System (INIS)

    Grigoriev, E.P.


    In even-even deformed nuclei up to now EO-transitions were found only between the states of the same spin belonging to Κ π = O + rotational bands. There is no forbidenness for EO-transitions between states belonging to bands with any other quantum number Κ provided both initial and final states have the same J π Κ values. EO-transitions may depopulate odd-parity states. In odd nuclei β-vibrational states are identified by transition with EO-components. Here transitions also proceed between states with the same J π K numbers. Even-even nuclide 160 Dy is the first nucleus where the EO-transitions between odd-parity states have been found

  16. Preliminary results of the comparative study between EO-1/Hyperion and ALOS/PALSAR (United States)

    Koizumi, E.; Furuta, R.; Yamamoto, A.


    [Introduction]Hyper-spectral remote sensing images have been used for land-cover classification due to their high spectral resolutions. Synthetic Aperture Radar (SAR) remote sensing data are also useful to probe surface condition because radar image reflects surface geometry, although there are not so many reports about the land-cover detection with combination use of both hyper-spectral data and SAR data. Among SAR sensors, L-band SAR is thought to be useful tool to find physical properties because its comparatively long wave length can through small objects on surface. We are comparing the result of land cover classification and/or physical values from hyper-spectral and L-band SAR data to find the relationship between these two quite different sensors and to confirm the possibility of the combined analysis of hyper-spectral and L-band SAR data, and in this presentation we will report the preliminary result of this study. There are only few sources of both hyper-spectral and L-band SAR data from the space in this time, however, several space organizations plan to launch new satellites on which hyper-spectral or L-band SAR equipments are mounted in next few years. So, the importance of the combined analysis will increase more than ever. [Target Area]We are performing and planning analyses on the following areas in this study. (a)South of Cairo, Nile river area, Egypt, for sand, sandstone, limestone, river, crops. (b)Mount Sakurajima, Japan, for igneous rock and other related geological property. [Methods and Results]EO-1 Hyperion data are analyzed in this study as hyper-spectral data. The Hyperion equipment has 242 channels but some of them include full noise or have no data. We selected channels for analysis by checking each channel, and select about 150 channels (depend on the area). Before analysis, the atmospheric correction of ATCOR-3 was applied for the selected channels. The corrected data were analyzed by unsupervised classification or principal component

  17. Spatial Variability Mapping of Crop Residue Using Hyperion (EO-1 Hyperspectral Data

    Directory of Open Access Journals (Sweden)

    Abderrazak Bannari


    Full Text Available Soil management practices that maintain crop residue cover and reduce tillage improve soil structure, increase organic matter content in the soil, positively influence water infiltration, evaporation and soil temperature, and play an important role in fixing CO2 in the soil. Consequently, good residue management practices on agricultural land have many positive impacts on soil quality, crop production quality and decrease the rate of soil erosion. Several studies have been undertaken to develop and test methods to derive information on crop residue cover and soil tillage using empirical and semi-empirical methods in combination with remote sensing data. However, these methods are generally not sufficiently rigorous and accurate for characterizing the spatial variability of crop residue cover in agricultural fields. The goal of this research is to investigate the potential of hyperspectral Hyperion (Earth Observing-1, EO-1 data and constrained linear spectral mixture analysis (CLSMA for percent crop residue cover estimation and mapping. Hyperion data were acquired together with ground-reference measurements for validation purposes at the beginning of the agricultural season (prior to spring crop planting in Saskatchewan (Canada. At this time, only bare soil and crop residue were present with no crop cover development. In order to extract the crop residue fraction, the images were preprocessed, and then unmixed considering the entire spectral range (427 nm–2355 nm and the pure spectra (endmember. The results showed that the correlation between ground-reference measurements and extracted fractions from the Hyperion data using CLMSA showed that the model was overall a very good predictor for crop residue percent cover (index of agreement (D of 0.94, coefficient of determination (R2 of 0.73 and root mean square error (RMSE of 8.7% and soil percent cover (D of 0.91, R2 of 0.68 and RMSE of 10.3%. This performance of Hyperion is mainly due to the

  18. Transitioning NPOESS Data to Weather Offices: The SPoRT Paradigm with EOS Data (United States)

    Jedlovec, Gary


    Real-time satellite information provides one of many data sources used by NWS weather forecast offices (WFOs) to diagnose current weather conditions and to assist in short-term forecast preparation. While GOES satellite data provides relatively coarse spatial resolution coverage of the continental U.S. on a 10-15 minute repeat cycle, polar orbiting imagery has the potential to provide snapshots of weather conditions at high-resolution in many spectral channels. Additionally, polar orbiting sounding data can provide additional information on the thermodynamic structure of the atmosphere in data sparse regions of at asynoptic observation times. The NASA Short-term Prediction Research and Transition (SPoRT) project has demonstrated the utility of polar orbiting MODIS and AIRS data on the Terra and Aqua satellites to improve weather diagnostics and short-term forecasting on the regional and local scales. SPoRT scientists work directly forecasters at selected WFOS in the Southern Region (SR) to help them ingest these unique data streams into their AWIPS system, understand how to use the data (through on-site and distance learn techniques), and demonstrate the utility of these products to address significant forecast problems. This process also prepares forecasters for the use of similar observational capabilities from NPOESS operational sensors. NPOESS environmental data records (EDRs) from the Visible 1 Infrared Imager I Radiometer Suite (VIIRS), the Cross-track Infrared Sounder (CrlS) and Advanced Technology Microwave Sounder (ATMS) instruments and additional value-added products produced by NESDIS will be available in near real-time and made available to WFOs to extend their use of NASA EOS data into the NPOESS era. These new data streams will be integrated into the NWs's new AWIPS II decision support tools. The AWIPS I1 system to be unveiled in WFOs in 2009 will be a JAVA-based decision support system which preserves the functionality of the existing systems and

  19. The Use of WhatsApp Smartphone Messaging Improves Communication Efficiency within an Orthopaedic Surgery Team. (United States)

    Ellanti, Prasad; Moriarty, Andrew; Coughlan, Fionn; McCarthy, Thomas


    Effective and timely communication is important for any surgical specialty to function. The use of smartphones is prevalent amongst doctors. Numerous smartphone applications offer the potential for fast and cost-effective communication. WhatsApp is a commonly used application that is free, easy to use, and capable of text and multimedia messaging. We report on the use of WhatsApp over a six month period in our unit. WhatsApp communication between non-consultant members of an orthopaedic team over a six-month period was analysed. Both the phones and the WhatsApp application were password-protected, and patient details were anonymised. A series of 20 communications using the hospital pager system and the telephone system were also analysed. A total of 5,492 messages were sent during the six-month period and were part of 1,916 separate communication events. The vast majority of messages, 5,090, were related to patient care. A total of 195 multimedia messages were sent and these included images of radiographs and wounds. When using the hospital telephones, the length of time spent on a communication averaged 5.78 minutes and using the hospital pager system averaged 7.45 minutes. Using the WhatsApp messaging system has potentially saved up to 7,664 minutes over the study period. All participants found WhatsApp easy to use and found it to be more efficient than the traditional pager system Conclusion: Compared to the traditional pager systems, the use of WhatsApp is easy, inexpensive, and reliable and can help improve the efficiency of communication within a surgical team.

  20. Early staphylococcal biofilm formation on solid orthopaedic implant materials: in vitro study.

    Directory of Open Access Journals (Sweden)

    Hironobu Koseki

    Full Text Available Biofilms forming on the surface of biomaterials can cause intractable implant-related infections. Bacterial adherence and early biofilm formation are influenced by the type of biomaterial used and the physical characteristics of implant surface. In this in vitro research, we evaluated the ability of Staphylococcus epidermidis, the main pathogen in implant-related infections, to form biofilms on the surface of the solid orthopaedic biomaterials, oxidized zirconium-niobium alloy, cobalt-chromium-molybdenum alloy (Co-Cr-Mo, titanium alloy (Ti-6Al-4V, commercially pure titanium (cp-Ti and stainless steel. A bacterial suspension of Staphylococcus epidermidis strain RP62A (ATCC35984 was added to the surface of specimens and incubated. The stained biofilms were imaged with a digital optical microscope and the biofilm coverage rate (BCR was calculated. The total amount of biofilm was determined with the crystal violet assay and the number of viable cells in the biofilm was counted using the plate count method. The BCR of all the biomaterials rose in proportion to culture duration. After culturing for 2-4 hours, the BCR was similar for all materials. However, after culturing for 6 hours, the BCR for Co-Cr-Mo alloy was significantly lower than for Ti-6Al-4V, cp-Ti and stainless steel (P0.05. These results suggest that surface properties, such as hydrophobicity or the low surface free energy of Co-Cr-Mo, may have some influence in inhibiting or delaying the two-dimensional expansion of biofilm on surfaces with a similar degree of smoothness.

  1. [The Development and Application of the Orthopaedics Implants Failure Database Software Based on WEB]. (United States)

    Huang, Jiahua; Zhou, Hai; Zhang, Binbin; Ding, Biao


    This article develops a new failure database software for orthopaedics implants based on WEB. The software is based on B/S mode, ASP dynamic web technology is used as its main development language to achieve data interactivity, Microsoft Access is used to create a database, these mature technologies make the software extend function or upgrade easily. In this article, the design and development idea of the software, the software working process and functions as well as relative technical features are presented. With this software, we can store many different types of the fault events of orthopaedics implants, the failure data can be statistically analyzed, and in the macroscopic view, it can be used to evaluate the reliability of orthopaedics implants and operations, it also can ultimately guide the doctors to improve the clinical treatment level.

  2. The First World War and its influence on the development of orthopaedic surgery. (United States)

    Scotland, T


    By December 1914, overwhelming numbers of soldiers with infected musculoskeletal wounds had filled hospitals in France and Britain. Frequently initial management had been inadequate. In 1915, patients with orthopaedic wounds were segregated for the first time when Robert Jones established an experimental orthopaedic unit in Alder Hey Hospital, Liverpool. In 1916 he opened the first of 17 orthopaedic centres in Britain to surgically treat and rehabilitate patients. Henry Gray from Aberdeen emerged as the leading authority in the management of acute musculoskeletal wounds in casualty clearing stations in France and Flanders. Gray had particular expertise in dealing with compound fractures of the femur for which he documented an 80% mortality rate in 1914-15.

  3. Surgical advances during the First World War: the birth of modern orthopaedics. (United States)

    Ramasamy, Arul; Eardley, W G P; Edwards, D S; Clasper, J C; Stewart, M P M


    The First World War (1914-1918) was the first truly industrial conflict in human history. Never before had rifle fire and artillery barrage been employed on a global scale. It was a conflict that over 4 years would leave over 750,000 British troops dead with a further 1.6 million injured, the majority with orthopaedic injuries. Against this backdrop, the skills of the orthopaedic surgeon were brought to the fore. Many of those techniques and systems form the foundation of modern orthopaedic trauma management. On the centenary of 'the War to end all Wars', we review the significant advances in wound management, fracture treatment, nerve injury and rehabilitation that were developed during that conflict. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  4. Bone Grafts, Substitutes, and Augments in Benign Orthopaedic Conditions Current Concepts. (United States)

    Blank, Alan; Riesgo, Aldo; Gitelis, Steven; Rapp, Timothy


    Musculoskeletal tumors are relatively rare diagnoses made by orthopaedic surgeons. While approximately 2,500 primary bone sarcomas are diagnosed annually in the USA, the number of benign orthopaedic tumors encountered annually is far more difficult to quantify. Some studies have documented between 3% and 10% of the general population having benign bony lesions. Many of these conditions can be simply observed, while others will require surgical intervention. Surgical treatments for benign conditions range from a one-step curettage to extensive resection and reconstruction. With treatment of larger lesions, significant bony defects may need to be addressed surgically. Treatment options have evolved over time with the use of various bone graft and bone void fillers, including methyl methacrylate cement, autograft, allograft bone chips, struts and osteoarticular segments, synthetic bone graft substitutes, and metal augments. This review provides an overview of the present status of bone graft, substitutes, and augment options for the orthopaedic surgeon treating benign musculoskeletal conditions.

  5. Skeletal metastases - the role of the orthopaedic and spinal surgeon. (United States)

    Eastley, Nicholas; Newey, Martyn; Ashford, Robert U


    Developments in oncological and medical therapies mean that life expectancy of patients with metastatic bone disease (MBD) is often measured in years. Complications of MBD may dramatically and irreversibly affect patient quality of life, making the careful assessment and appropriate management of these patients essential. The roles of orthopaedic and spinal surgeons in MBD generally fall into one of four categories: diagnostic, the prophylactic fixation of metastatic deposits at risk of impending fracture (preventative surgery), the stabilisation or reconstruction of bones affected by pathological fractures (reactive surgery), or the decompression and stabilisation of the vertebral column, spinal cord, and nerve roots. Several key principals should be adhered to whenever operating on skeletal metastases. Discussions should be held early with an appropriate multi-disciplinary team prior to intervention. Detailed pre-assessment is essential to gauge a patient's suitability for surgery - recovery from elective surgery must be shorter than the anticipated survival. Staging and biopsies provide prognostic information. Primary bone tumours must be ruled out in the case of a solitary bone lesion to avoid inappropriate intervention. Prophylactic surgical fixation of a lesion prior to a pathological fracture reduces morbidity and length of hospital stay. Regardless of a lesion or pathological fracture's location, all regions of the affected bone must be addressed, to reduce the risk of subsequent fracture. Surgical implants should allow full weight bearing or return to function immediately. Post-operative radiotherapy should be utilised in all cases to minimise disease progression. Spinal surgery should be considered for those with spinal pain due to potentially reversible spinal instability or neurological compromise. The opinion of a spinal surgeon should be sought early, as delays in referral directly correlate to worse functional recovery following intervention

  6. Evaluation of Patient Satisfaction Surveys in Pediatric Orthopaedics. (United States)

    Segal, Lee S; Plantikow, Carla; Hall, Randon; Wilson, Kristina; Shrader, M Wade


    Patient satisfaction survey scores are increasingly being tied to incentive compensation, impact how we practice medicine, influence decisions on where patients seek care, and in the future may be required for accreditation. The goal of this study is to compare the results of an internal distribution of patient satisfaction surveys at the point of care to responses received by mail in a hospital-based, high-volume pediatric orthopaedic practice. A pediatric outpatient survey is used at our institution to evaluate patient satisfaction. Surveys are randomly mailed out to families seen in our clinic by the survey vendor, and the results are determined on a quarterly basis. We distributed the same survey in a similar manner in our clinic. The results of the surveys, external/mailed (EXM) versus internal/point of care (INP) over the same 3-month time period (second quarter 2013) were compared. The survey questions are dichotomized from an ordinal scale into either excellent (9 to 10) or not excellent (0 to 8) commonly used in patient satisfaction methodology. We evaluated the raw data from the INP surveys for the question on provider rating by evaluating the mean score, the standard excellent response (9 to 10), and an expanded excellent response (8 to 10). Response rate was 72/469 (15.4%) for EXM, and 231/333 (69.4%) for INP. An excellent response for the "rating your provider" question was 72.2% (EXM) versus 84.8% (INP) (P=0.015). Our analysis of the raw data (INP) has a mean rating of 9.42. The expanded scale (8 to 10) for an excellent response increased the provider rating to 94.4% (P=0.001). Waiting time response within 15 minutes was the only item that correlated with rating of provider (P=0.02). For the majority of the items, the INP responses were consistently higher than the EXM responses, including 6/7 responses that were statistically significant (Ppatient satisfaction surveys will be important in determining health care outcomes. Properly designed and

  7. Biologic-free remission by orthopaedic surgery in non-responder to infliximab for rheumatoid arthritis. (United States)

    Kanbe, Katsuaki; Chiba, Junji; Inoue, Yasuo; Taguchi, Masashi; Yabuki, Akiko


    The aim of this study was to investigate remission and biologic-free remission after orthopaedic surgery and related clinical factors in non-responder to infliximab for rheumatoid arthritis (RA). We analyzed 74 patients who were treated with 3 mg/kg infliximab and methotrexate and underwent orthopaedic surgery after non-responder to infliximab with disease activity score (DAS) 28 (CRP) of ≥3.2. The rates of remission and biologic-free remission at 52 weeks after orthopaedic surgery were investigated and the clinical factors related to remission and biologic-free remission were analyzed by logistic regression and receiver-operating characteristic analyses. The rates of total remission and biologic-free remission were 37/74 (50 %) and 9/74 (12.2 %), respectively. Regarding orthopaedic surgery, the rates of remission and biologic-free remission were 25/38 (65.8 %) and 7/38 (18.4 %) for synovectomy, 7/20 (35 %) and 0/20 (0 %) for arthroplasty, and 5/16 (31.3 %) and 2/16 12.5) for others including spine surgery and foot surgery. DAS28(CRP) at baseline was significantly related to both remission and biologic-free remission. Prednisolone was negatively associated with remission, and DAS28(CRP) was related to biologic-free remission by logistic regression analyses. DAS28(CRP) below 3.7 was cutoff point for acquiring biologic-free remission of non-responder to infliximab after orthopaedic surgery. Therefore orthopaedic surgery may be effective to obtain remission or biologic-free remission in RA patients treated with biologics.

  8. Postinjury Anxiety and Social Support Among Collegiate Athletes: A Comparison Between Orthopaedic Injuries and Concussions (United States)

    Covassin, Tracey; Crutcher, Bryan; Bleecker, Alisha; Heiden, Erin O.; Dailey, Alexander; Yang, Jingzhen


    Context: When an athlete is injured, the primary focus of the sports medicine team is to treat the physical effects of the injury. However, many injured athletes experience negative psychological responses, including anxiety, regarding their injury. Objective: To compare the anxiety and social support of athletes with concussions and a matched group of athletes with orthopaedic injuries. Design: Cross-sectional study. Setting: Athletic training room. Patients or Other Participants: A total of 525 injuries among athletes from 2 Big Ten universities were observed. Of these, 63 concussion injuries were matched with 63 orthopaedic injuries for the athlete's sex, sport, and time loss due to injury. Main Outcome Measure(s): Clinical measures included the State-Trait Anxiety Inventory (which measures both state and trait anxiety) and the modified 6-item Social Support Questionnaire. Results: The group with concussions relied on their family for social support 89% of the time, followed by friends (78%), teammates (65%), athletic trainers (48%), coaches (47%), and physicians (35%). The group with orthopaedic injuries relied on their family for social support 87% of the time, followed by friends (84%), teammates (65%), athletic trainers (57%), coaches (51%), and physicians (36%). We found no differences for the State-Trait Anxiety Inventory (t = −1.38, P = .193) between the concussed and orthopaedic-injury groups. Social Support Questionnaire scores were significant predictors for postinjury state anxiety. Specifically, increased scores were associated with decreased postinjury state anxiety (β = −4.21, P = .0001). Conclusions: Both the concussed athletes and those with orthopaedic injuries experienced similar state and trait anxiety and relied on similar sources of social support postinjury. However, athletes with orthopaedic injuries reported greater satisfaction with support from all sources compared with concussed athletes. In contrast, concussed athletes showed

  9. Postinjury anxiety and social support among collegiate athletes: a comparison between orthopaedic injuries and concussions. (United States)

    Covassin, Tracey; Crutcher, Bryan; Bleecker, Alisha; Heiden, Erin O; Dailey, Alexander; Yang, Jingzhen


    When an athlete is injured, the primary focus of the sports medicine team is to treat the physical effects of the injury. However, many injured athletes experience negative psychological responses, including anxiety, regarding their injury. To compare the anxiety and social support of athletes with concussions and a matched group of athletes with orthopaedic injuries. Cross-sectional study. Athletic training room. A total of 525 injuries among athletes from 2 Big Ten universities were observed. Of these, 63 concussion injuries were matched with 63 orthopaedic injuries for the athlete's sex, sport, and time loss due to injury. Clinical measures included the State-Trait Anxiety Inventory (which measures both state and trait anxiety) and the modified 6-item Social Support Questionnaire. The group with concussions relied on their family for social support 89% of the time, followed by friends (78%), teammates (65%), athletic trainers (48%), coaches (47%), and physicians (35%). The group with orthopaedic injuries relied on their family for social support 87% of the time, followed by friends (84%), teammates (65%), athletic trainers (57%), coaches (51%), and physicians (36%). We found no differences for the State-Trait Anxiety Inventory (t = -1.38, P = .193) between the concussed and orthopaedic-injury groups. Social Support Questionnaire scores were significant predictors for postinjury state anxiety. Specifically, increased scores were associated with decreased postinjury state anxiety (β = -4.21, P = .0001). Both the concussed athletes and those with orthopaedic injuries experienced similar state and trait anxiety and relied on similar sources of social support postinjury. However, athletes with orthopaedic injuries reported greater satisfaction with support from all sources compared with concussed athletes. In contrast, concussed athletes showed more significant predictor models of social support on state anxiety at return to play.

  10. Development and reproducibility of a short questionnaire to measure use and usability of custom-made orthopaedic shoes

    NARCIS (Netherlands)

    van Netten, Jaap J.; Hijmans, Juha M.; Jannink, M.J.A.; Geertzen, Jan H.B.; Postema, Klaas


    Objective: To develop a short and easy to use questionnaire to measure use and usability of custom-made orthopaedic shoes, and to investigate its reproducibility. Design: Development of the questionnaire (Monitor Orthopaedic Shoes) was based on a literature search, expert interviews, 2 expert


    NARCIS (Netherlands)

    van Netten, Jaap J.; Hijmans, Juha M.; Jannink, Michiel J. A.; Geertzen, Jan H. B.; Postema, Klaas


    Objective:To develop it short and easy to use questionnaire to measure use and usability of custom-made orthopaedic shoes, and to investigate its reproducibility. Design: Development of the questionnaire (Monitor Orthopaedic Shoes) was based on a literature search. expert interviews. 2 expert

  12. Multicenter collaborative for orthopaedic research in India: An opportunity for global leadership

    Directory of Open Access Journals (Sweden)

    Mathew George


    Full Text Available Road traffic accidents are increasing at an alarming rate and have become a major public health concern in India. In addition, there is a lack of trauma research output and reliable data from India. There are several issues and challenges that have presented an opportunity for researchers and surgeons in India to develop a collaborative aimed at improving the quality and productivity of orthopaedic trauma research. Establishing a network of surgical researchers across India is a necessary first step towards global leadership in orthopaedic surgery trials.

  13. Mesoscopic Simulations of the Phase Behavior of Aqueous EO 19 PO 29 EO 19 Solutions Confined and Sheared by Hydrophobic and Hydrophilic Surfaces

    KAUST Repository

    Liu, Hongyi


    The MesoDyn method is used to investigate associative structures in aqueous solution of a nonionic triblock copolymer consisting of poly(propylene oxide) capped on both ends with poly(ethylene oxide) chains. The effect of adsorbing (hydrophobic) and nonadsorbing (hydrophilic) solid surfaces in contact with aqueous solutions of the polymer is elucidated. The macromolecules form self-assembled structures in solution. Confinement under shear forces is investigated in terms of interfacial behavior and association. The formation of micelles under confinement between hydrophilic surfaces occurs faster than in bulk aqueous solution while layered structures assemble when the polymers are confined between hydrophobic surfaces. Micelles are deformed under shear rates of 1 μs -1 and eventually break to form persistent, adsorbed layered structures. As a result, surface damage under frictional forces is prevented. Overall, this study indicates that aqueous triblock copolymers of poly(ethylene oxide) (PEO) and poly(propylene oxide) (PPO) (Pluronics, EO mPO nEO m) act as a boundary lubricant for hydrophobic surfaces but not for hydrophilic ones. © 2011 American Chemical Society.

  14. EO-Performance relationships in Reverse Internationalization by Chinese Global Startup OEMs: Social Networks and Strategic Flexibility (United States)

    Chin, Tachia; Tsai, Sang-Bing; Fang, Kai; Zhu, Wenzhong; Yang, Dongjin; Liu, Ren-huai; Tsuei, Richard Ting Chang


    Due to the context-sensitive nature of entrepreneurial orientation (EO), it is imperative to in-depth explore the EO-performance mechanism in China at its critical, specific stage of economic reform. Under the context of “reverse internationalization” by Chinese global startup original equipment manufacturers (OEMs), this paper aims to manifest the unique links and complicated interrelationships between the individual EO dimensions and firm performance. Using structural equation modeling, we found that during reverse internationalization, proactiveness is positively related to performance; risk taking is not statistically associated with performance; innovativeness is negatively related to performance. The proactiveness-performance relationship is mediated by Strategic flexibility and moderated by social networking relationships. The dynamic and complex institutional setting, coupled with the issues of overcapacity and rising labor cost in China may explain why our distinctive results occur. This research advances the understanding of how contingent factors (social network relationships and strategic flexibility) facilitate entrepreneurial firms to break down institutional barriers and reap the most from EO. It brings new insights into how Chinese global startup OEMs draw on EO to undertake reverse internationalization, responding the calls for unraveling the heterogeneous characteristics of EO sub-dimensions and for more contextually-embedded treatment of EO-performance associations. PMID:27631368

  15. New insights into the operative network of FaEO, an enone oxidoreductase from Fragaria x ananassa Duch. (United States)

    Collu, Gabriella; Farci, Domenica; Esposito, Francesca; Pintus, Francesca; Kirkpatrick, Joanna; Piano, Dario


    The 2-methylene-furan-3-one reductase or Fragaria x ananassa Enone Oxidoreductase (FaEO) catalyses the last reductive step in the biosynthesis of 4-hydroxy-2,5-dimethyl-3(2H)-furanone, a major component in the characteristic flavour of strawberries. In the present work, we describe the association between FaEO and the vacuolar membrane of strawberry fruits. Even if FaEO lacks epitopes for stable or transient membrane-interactions, it contains a calmodulin-binding region, suggesting that in vivo FaEO may be associated with the membrane via a peripheral protein complex with calmodulin. Moreover, we also found that FaEO occurs in dimeric form in vivo and, as frequently observed for calmodulin-regulated proteins, it may be expressed in different isoforms by alternative gene splicing. Further mass spectrometry analysis confirmed that the isolated FaEO consists in the already known isoform and that it is the most characteristic during ripening. Finally, a characterization by absorption spectroscopy showed that FaEO has specific flavoprotein features. The relevance of these findings and their possible physiological implications are discussed.

  16. EO-Performance relationships in Reverse Internationalization by Chinese Global Startup OEMs: Social Networks and Strategic Flexibility. (United States)

    Chin, Tachia; Tsai, Sang-Bing; Fang, Kai; Zhu, Wenzhong; Yang, Dongjin; Liu, Ren-Huai; Tsuei, Richard Ting Chang


    Due to the context-sensitive nature of entrepreneurial orientation (EO), it is imperative to in-depth explore the EO-performance mechanism in China at its critical, specific stage of economic reform. Under the context of "reverse internationalization" by Chinese global startup original equipment manufacturers (OEMs), this paper aims to manifest the unique links and complicated interrelationships between the individual EO dimensions and firm performance. Using structural equation modeling, we found that during reverse internationalization, proactiveness is positively related to performance; risk taking is not statistically associated with performance; innovativeness is negatively related to performance. The proactiveness-performance relationship is mediated by Strategic flexibility and moderated by social networking relationships. The dynamic and complex institutional setting, coupled with the issues of overcapacity and rising labor cost in China may explain why our distinctive results occur. This research advances the understanding of how contingent factors (social network relationships and strategic flexibility) facilitate entrepreneurial firms to break down institutional barriers and reap the most from EO. It brings new insights into how Chinese global startup OEMs draw on EO to undertake reverse internationalization, responding the calls for unraveling the heterogeneous characteristics of EO sub-dimensions and for more contextually-embedded treatment of EO-performance associations.

  17. Worldwide orthopaedic research activity 2010-2014: Publication rates in the top 15 orthopaedic journals related to population size and gross domestic product. (United States)

    Hohmann, Erik; Glatt, Vaida; Tetsworth, Kevin


    To perform a bibliometric analysis of publications rates in orthopedics in the top 15 orthopaedic journals. Based on their 2015 impact factor, the fifteen highest ranked orthopaedic journals between January 2010 and December 2014 were used to establish the total number of publications; cumulative impact factor points (IF) per country were determined, and normalized to population size, GDP, and GDP/capita, comparison to the median country output and the global leader. Twenty-three thousand and twenty-one orthopaedic articles were published, with 66 countries publishing. The United States had 8149 publications, followed by the United Kingdom (1644) and Japan (1467). The highest IF was achieved by the United States (24744), United Kingdom (4776), and Japan (4053). Normalized by population size Switzerland lead. Normalized by GDP, Croatia was the top achiever. Adjusting GDP/capita, for publications and IF, China, India, and the United States were the leaders. Adjusting for population size and GDP, 28 countries achieved numbers of publications to be considered at least equivalent with the median academic output. Adjusting GDP/capita only China and India reached the number of publications to be considered equivalent to the current global leader, the United States. Five countries were responsible for 60% of the orthopaedic research output over this 5-year period. After correcting for GDP/capita, only 28 of 66 countries achieved a publication rate equivalent to the median country. The United States, United Kingdom, South Korea, Japan, and Germany were the top five countries for both publication totals and cumulative impact factor points.

  18. Differences between orthopaedic evaluation and radiological reports of conventional radiographs in patients with minor trauma admitted to the emergency department. (United States)

    Catapano, Michele; Albano, Domenico; Pozzi, Grazia; Accetta, Riccardo; Memoria, Sergio; Pregliasco, Fabrizio; Messina, Carmelo; Sconfienza, Luca Maria


    During night and on weekends, in our emergency department there is no radiologist on duty or on call: thus, X-ray examinations (XR) are evaluated by the orthopaedic surgeon on duty and reported the following morning/monday by radiologists. The aim of our study was to examine the discrepancy rate between orthopaedists and radiologists in the interpretation of imaging examinations performed on patients in our tertiary level orthopaedic institution and the consequences of delayed diagnosis in terms of patient management and therapeutic strategy. We retrospectively reviewed all cases of discrepancy between orthopaedists and radiologists, which were categorized according to anatomical location of injury, initial diagnosis and treatment, change in diagnosis and treatment. We used the Chi square test to compare the frequencies of discrepancies between patients ≤14 and >14years of age. From January to December 2016, 19,512 patients admitted to our emergency department performed at least an imaging examination; among these patients, 13,561 underwent XR in absence of an attending radiologist. A discrepant diagnosis was found in 337/13,561 (2.5%; 184 males; mean age: 36.7±23.7, range 2-95); 151/337 (45%) discrepancies were encountered in the lower limbs, with ankle being the most common site of misdiagnosis (64/151), and 103/337 (30%) in the upper limbs, with the elbow being the most frequent site in this district (35/103). We found 293/337 false negatives (87%) and 44/337 false positives (13%), with 134 and 13 patients needing treatment change, respectively. We found 85/337 discrepancies (25%) in patients ≤14 years of age, and 252/337 (75%) in those >14years. The distribution of discrepancies per anatomic district was significantly different (P<0.001) in these two groups of patients. A low rate of discrepancy between orthopaedists and radiologists in evaluating images of patients admitted to our emergency department was found, although treatment change occurred in about

  19. Application of SPDT technology in the field of EOS target fabrication

    International Nuclear Information System (INIS)

    Xie Jun; Huang Yanhua; Zhao Liping; Li Chaoyang; Du Kai; Tong Weichao; Yuan Guanghui; Yi Taimin; Zheng Fengcheng; Xing Pifeng


    The technology of single point diamond turning (SPDT) is capable of achieving sample surface roughness of less than 10 nm and shape accuracy of less than 100 nm, which are crucial parameters for ultra precision machining. In research of equation of state (EOS) of materials, a target must have a surface roughness of less than 50 nm, a thickness uniformity of over 98%, and a maximum peak-to-valley height of less than 200 nm, with a proximity theatrical density. A target fabricated by SPDT has the same density as the original material, with required machining precision and surface roughness. In this paper, we report some SPDT applications in laser EOS targets fabrication, which include planar-shaped, step-shaped, and wedge-shaped targets with copper or aluminum. (authors)

  20. Risk reduction methodologies and technologies for the Earth Observing System (EOS) Operations Center (EOC) (United States)

    Hudson, Richard K.; Pingitore, Nelson V.


    This paper will discuss proposed Flight Operations methodologies and technologies for the Earth Observing System (EOS) Operations Center (EOC), to reduce risks associated with the operation of complex multi-instrument spacecraft in a multi-spacecraft environment. The EOC goals are to obtain 100 percent science data capture and maintain 100 percent spacecraft health, for each EOS spacecraft. Operations risks to the spacecraft and data loss due to operator command error, mission degradation due to mis-identification of an anomalous trend in component performance or mis-management of resources, and total mission loss due to improper subsystem configuration or mis-identification of an anomalous condition. This paper discusses automation of routine Flight Operations Team (FOT) responsibilities, Expert systems for real-time non-nominal condition decision support, and Telemetry analysis systems for in-depth playback data analysis and trending.

  1. An interpretation of the behavior of EoS/GE models for asymmetric systems

    DEFF Research Database (Denmark)

    Kontogeorgis, Georgios; Panayiotis, Vlamos


    or zero pressure or at other conditions (system's pressure, constant volume packing fraction). In a number of publications over the last years, the achievements and the shortcomings of the various EoS/G(E) models have been presented via phase equilibrium calculations. This short communication provides...... an explanation of several literature EoSIGE models, especially those based on zero-reference pressure (PSRK, MHV1, MHV2), in the prediction of phase equilibria for asymmetric systems as well as an interpretation of the LCVM and kappa-MHV1 models which provide an empirical - yet as shown here theoretically...... justified - solution to these problems. (C) 2000 Elsevier Science Ltd. All rights reserved....

  2. The Experience and Effectiveness of Nurse Practitioners in Orthopaedic Settings: A Comprehensive Systematic Review. (United States)

    Taylor, Anita; Staruchowicz, Lynda


    This review asks "What is the experience and effectiveness of nurse practitioners in orthopaedic settings"?The objective of the quantitative component of this review is to synthesise the best available evidence on effectiveness of orthopaedic nurse practitioner specific care on patient outcomes and process indicators.The objective of the qualitative component of this review is to synthesise the best available evidence on the experience of becoming or being an orthopaedic nurse practitioner in relation to role development, role implementation and (ongoing) role evaluation.The objective of the text and opinion component of this review is to synthesise the best available evidence of the contemporary discourse on the effectiveness and experience of nurse practitioners in orthopaedic settings. Nurse practitioner roles have emerged in response to areas of unmet healthcare needs in a variety of settings. Nurse practitioners first evolved in the United States 40 years ago in response to a shortage of primary health care physicians. Nurse practitioners filled the void by providing access to primary health care services where otherwise there was none. Nurse practitioners comprise one branch of advanced nursing practice in the US along with Nurse Anaesthetists (NA), Clinical Nurse Specialists (CNS) and Nurse Midwives (NM). Canada soon followed America's lead by establishing the nurse practitioner role in 1967. Canada has two areas of advanced nursing practice, namely nurse practitioner and clinical nurse specialist; they are moving towards introducing nurse anaesthetists currently. The nurse practitioner role was introduced into the United Kingdom 20 years ago.There is commonality amongst the definition and characteristics of Nurse Practitioner (NP)/Advanced Practice Nurse (APN) role and practice internationally in terms of education, practice standards and regulation; operationally there is variability however. Australia's progress with nurse practitioners is very much

  3. Evaluation of software based redundancy algorithms for the EOS storage system at CERN

    International Nuclear Information System (INIS)

    Peters, Andreas-Joachim; Sindrilaru, Elvin Alin; Zigann, Philipp


    EOS is a new disk based storage system used in production at CERN since autumn 2011. It is implemented using the plug-in architecture of the XRootD software framework and allows remote file access via XRootD protocol or POSIX-like file access via FUSE mounting. EOS was designed to fulfill specific requirements of disk storage scalability and IO scheduling performance for LHC analysis use cases. This is achieved by following a strategy of decoupling disk and tape storage as individual storage systems. A key point of the EOS design is to provide high availability and redundancy of files via a software implementation which uses disk-only storage systems without hardware RAID arrays. All this is aimed at reducing the overall cost of the system and also simplifying the operational procedures. This paper presents the advantages and disadvantages of redundancy by hardware (most classical storage installations) in comparison to redundancy by software. The latter is implemented in the EOS system and achieves its goal by spawning data and parity stripes via remote file access over nodes. The gain in redundancy and reliability comes with a trade-off in the following areas: • Increased complexity of the network connectivity • CPU intensive parity computations during file creation and recovery • Performance loss through remote disk coupling An evaluation and performance figures of several redundancy algorithms are presented for dual parity RAID and Reed-Solomon codecs. Moreover, the characteristics and applicability of these algorithms are discussed in the context of reliable data storage systems.

  4. NASA's Earth Observing System (EOS): Observing the Atmosphere, Land, Oceans, and Ice from Space (United States)

    King, Michael D.


    The Earth Observing System (EOS) is a space-based observing system comprised of a series of satellite sensors by whch scientists can monitor the Earth, a Data and Information System (EOSDIS) enabling researchers worldwide to access the satellite data, and an interdisciplinary science research program to interpret the satellite data. During this year, the last of the first series of EOS missions, Aura, was launched. Aura is designed exclusively to conduct research on the composition, chemistry, and dynamics of the Earth's upper and lower atmosphere, employing multiple instruments on a single spacecraft. Aura is the third in a series of major Earth observing satellites to study the environment and climate change and is part of NASA's Earth Science Enterprise. The first and second missions, Terra and Aqua, are designed to study the land, oceans, atmospheric constituents (aerosols, clouds, temperature, and water vapor), and the Earth's radiation budget. The other seven EOS spacecraft include satellites to study (i) land cover & land use change, (ii) solar irradiance and solar spectral variation, (iii) ice volume, (iv) ocean processes (vector wind and sea surface topography), and (v) vertical variations of clouds, water vapor, and aerosols up to and including the stratosphere. Aura's chemistry measurements will also follow up on measurements that began with NASA's Upper Atmosphere Research Satellite and continue the record of satellite ozone data collected from the TOMS missions. In this presentation I will describe how scientists are using EOS data to examine the health of the earth's atmosphere, including atmospheric chemistry, aerosol properties, and cloud properties, with a special look at the latest earth observing mission, Aura.

  5. Use Of EOS-AURA Observation In The MERRA-2 Reanalysis (United States)

    Pawson, Steven; Wargan, Krzysztof; Coy, Lawrence L.; McCarty, Will


    Meteorological reanalyses provide multi-year gridded datasets that describe the evolution of the atmosphere. Such products use a data assimilation system, comprising of an atmospheric model, a broad suite of observations, and an analysis system that optimally combines the model forecast with the observations, using an algorithm that includes information about model and data accuracy. The mixture of observations is of central importance to the quality of the assimilated datasets. The Modern-era Retrospective Analysis for Research and Applications (MERRA) included constraints on the thermal structure of the middle atmosphere from nadir sounders on the NOAA polar-orbiting platforms (Stratospheric Sounding Units and Advanced Microwave Sounding Units). These instruments have peak sensitivities that occur well below the stratopause. As such, the radiance measurements do not provide strong constraints on stratopause temperature. The new MERRA-2 reanalysis is using EOS-MLS temperature retrievals after they are available: it will be demonstrated that these data lead to a more realistic stratopause structure in MERRA-2 than in MERRA. Similarly, the work demonstrates the improvements in lower stratospheric ozone in MERRA-2 than in MERRA, for the period when EOS-MLS ozone data are assimilated. This improvement occurs because of the ozone profile information offered by MLS in the low stratosphere, in contrast to the SBUV/2 data used for the rest of MERRA-2. The impacts of choosing to use the EOS-MLS datasets are discussed in context of the continuity of the data record in MERRA- 2.

  6. Modification of Peng Robinson EOS for modelling (vapour + liquid) equilibria with electrolyte solutions

    International Nuclear Information System (INIS)

    Baseri, Hadi; Lotfollahi, Mohammad Nader


    Highlights: → Extended PR-EOS was presented for VLE of H 2 O/Salt/CO 2 systems at high pressure. → The proposed EPR-EOS is based upon contributions to the Helmholtz energy. → Born, Margules, and Debye-Huckel or mean spherical approximation terms were used. → Two different mixing rules Panagiotopoulos and Reid and Kwak and Mansoori (KM) were used. → A combination of KM mixing rule with DH term results more accurate VLE results. - Abstract: A modification of the extended Peng-Robinson equation of state (PR-EOS) is presented to describe the (vapour + liquid) equilibria of systems containing water and salts. The modification employs three additional terms including a Born term, a Margules term and two terms separately used for estimation of the long-range electrostatic interactions (the Debye-Huckel (DH) or the mean spherical approximation (MSA) terms). Effects of two mixing rules, first, the Panagiotopoulos and Reid mixing rule (PR) and, second, the Kwak and Mansoori mixing rule (KM), on the final values of VLE calculations are also investigated. The results show that the KM mixing rule is more appropriate than the PR mixing rule. The proposed equation of state is used to calculate the (vapour + liquid) equilibrium (VLE) of the systems containing (water + sodium sulphate + carbon dioxide) and (water + sodium chloride + carbon dioxide) at high pressure. The comparison of calculated results with the experimental data shows that a combination of KM mixing rule with the DH term results a more accurate VLE values.

  7. Estimation of Minimum Miscibility Pressure for 〖CO〗_2 Flood Based on EOS

    Directory of Open Access Journals (Sweden)

    Sameera Hamd-allah


    Full Text Available CO2 Gas is considered one of the unfavorable gases and it causes great air pollution. It’s possible to decrease this pollution by injecting gas in the oil reservoirs to provide a good miscibility and to increase the oil recovery factor. MMP was estimated by Peng Robinson equation of state (PR-EOS. South Rumila-63 (SULIAY is involved for which the miscible displacement by is achievable based on the standard criteria for success EOR processes. A PVT report was available for the reservoir under study. It contains deferential liberation (DL and constant composition expansion (CCE tests. PVTi software is one of the (Eclipse V.2010 software’s packages, it has been used to achieve the goal. Many trials have been done to match the data of DL test by tuning some of the PR-EOS parameters through the regression analysis process, but no acceptable match was obtained especially for saturation pressure. However; splitting the mole fraction of (C6+ to many pseudo components was carried out, and then a regression analysis process was made again to improve the matching by tuning some of the PR-EOS parameters. A good estimate of saturation pressure and a good match of PVT properties was noted. Ternary diagram has been constructed to represent the phase behavior of -Oil and to calculate MMP for the South Rumila-63 (SULIAY oil well.

  8. EOS as the present and future solution for data storage at CERN

    CERN Document Server

    Peters, AJ; Adde, G


    EOS is an open source distributed disk storage system in production since 2011 at CERN. Development focus has been on low-latency analysis use cases for LHC(1) and non- LHC experiments and life-cycle management using JBOD(2) hardware for multi PB storage installations. The EOS design implies a split of hot and cold storage and introduced a change of the traditional HSM(3) functionality based workflows at CERN.The 2015 deployment brings storage at CERN to a new scale and foresees to breach 100 PB of disk storage in a distributed environment using tens of thousands of (heterogeneous) hard drives. EOS has brought to CERN major improvements compared to past storage solutions by allowing quick changes in the quality of service of the storage pools. This allows the data centre to quickly meet the changing performance and reliability requirements of the LHC experiments with minimal data movements and dynamic reconfiguration. For example, the software stack has met the specific needs of the dual computing centre set-...

  9. Combining Clinical Information and Patient Reported Outcome Measures in Orthopaedic Surgery and Sports Medicine

    NARCIS (Netherlands)

    Kampen, D.A. van


    In this thesis we investigated the use of clinical information and Patient Reported Outcome Measures (PROMs) for patient evaluation in orthopaedic surgery and sports medicine. In the first part, we showed that the Dutch version of the Simple Shoulder Test (SST) is a valid and reliable

  10. Trauma Collaborative Care Intervention: Effect on Surgeon Confidence in Managing Psychosocial Complications After Orthopaedic Trauma. (United States)

    Wegener, Stephen T; Carroll, Eben A; Gary, Joshua L; McKinley, Todd O; OʼToole, Robert V; Sietsema, Debra L; Castillo, Renan C; Frey, Katherine P; Scharfstein, Daniel O; Huang, Yanjie; Collins, Susan C J; MacKenzie, Ellen J


    The impact of the Trauma Collaborative Care (TCC) program on surgeon confidence in managing the psychosocial sequelae of orthopaedic trauma was evaluated as part of a larger prospective, multisite, cluster clinical trial. We compared confidence and perceived resource availability among surgeons practicing in trauma centers that implemented the TCC program with orthopaedic trauma surgeons in similar trauma centers that did not implement the TCC. Prospective cohort design. Level-I trauma centers. Attending surgeons and fellows (N = 95 Pre and N = 82 Post). Self-report 10-item measure of surgeon confidence in managing psychosocial issues associated with trauma and perceived availability of support resources. Analyses, performed on the entire sample and repeated on the subset of 52 surgeons who responded to the survey at both times points, found surgeons at intervention sites experienced a significantly greater positive improvement (P < 0.05) in their (1) belief that they have strategies to help orthopaedic trauma patients change their psychosocial situation; (2) confidence in making appropriate referrals for orthopaedic trauma patients with psychosocial problems; and (3) belief that they have access to information to guide the management of psychosocial issues related to recovery. Initial data suggest that the establishment of the TCC program can improve surgeons' perceived availability of resources and their confidence in managing the psychosocial sequelae after injury. Further studies will be required to determine if this translates into beneficial patient effects. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

  11. What influences a patient's decision to use custom-made orthopaedic shoes?

    NARCIS (Netherlands)

    van Netten, Jaap J.; Dijkstra, Pieter U.; Geertzen, Jan H. B.; Postema, Klaas


    Background: Despite potential benefits, some patients decide not to use their custom-made orthopaedic shoes (OS). Factors are known in the domains 'usability', 'communication and service', and 'opinion of others' that influence a patient's decision to use OS. However, the interplay between these

  12. Hydrolytic Decomposition in a Polyamide/PDMS Composite for Orthopaedic Usage

    Czech Academy of Sciences Publication Activity Database

    Sochor, M.; Balík, Karel; Sucharda, Zbyněk; Suchý, Tomáš; Sedláček, R.


    Roč. 14, č. 103 (2011), s. 2-3 ISSN 1429-7248 R&D Projects: GA ČR(CZ) GAP108/10/1457 Institutional research plan: CEZ:AV0Z30460519 Keywords : composite * hydrolic decomposition * orthopaedics Subject RIV: BO - Biophysics

  13. The Orthopaedic Training Study, Phase II 1968-1972. Final Report Supplement, Psychomotor Skills, Part B. (United States)

    Olson, Carl J.; And Others

    This document, as a supplement to the final report of the Orthopaedic Training Study, presents a discussion of the rationale behind the implementation of a laboratory course in psychomotor skills development for medical students. Medical educators examined resident training in terms of 3 components of cognitive elements of learning: cognitive,…

  14. European Working Time Directive and the use of simulators and models in Irish orthopaedics.

    LENUS (Irish Health Repository)

    Egan, C


    OBJECTIVE: To report on the perceptions of a group of orthopaedic trainees and trainers on perceived effects of the proposed introduction of European Working Time Directive (EWTD) restrictions into Ireland and on the use of simulators in training orthopaedic skills. METHODS: A structured questionnaire was developed to evaluate the opinions of a group of orthopaedic surgeons and trainees at the annual national orthopaedic conference. RESULTS: There were 44 participants [12 consultants, 32 trainees (15 specialist registrars, 8 registrars, 9 senior house officers)]. Seventy-five percent of participants felt that both the quality of patient care and training would be negatively affected. A higher proportion of consultants than trainees felt that quality of life would be affected. A high proportion of participants (81.8%) had used a simulator or model to learn a surgical skill and 100% would consider using them again. CONCLUSIONS: While we wait for the full introduction of the EWTD hours the perception is that both quality of patient care and training will be affected. Models and simulators are well perceived as a method of training.

  15. [Structured Outpatient Care in a New Orthopaedic Healthcare Program: Patients' Experiences as Criterion for Quality

    NARCIS (Netherlands)

    Klingenberg, A.; Kaufmann-Kolle, P.; Wensing, M.; Gotz, K.; Jahed, J.; Lembeck, B.; Flechtenmacher, J.; Kazmaier, T.; Szecsenyi, J.


    Background In 2015 a survey was conducted in Baden-Wurttemberg (Germany) among patients treated by orthopaedic specialists participating in a medical specialists' contract between doctors and statutory health insurance funds, in accordance with section sign 73c of the German Social Code, Book V (SGB

  16. An observational audit of pain scores post-orthopaedic surgery at a ...

    African Journals Online (AJOL)

    Objectives: The aim was to determine whether postoperative pain is satisfactorily controlled in patients undergoing orthopaedic surgery at a level two state hospital in Cape Town. Design: Two observational audits were performed 12 months apart as part of a full audit cycle. Setting and subjects: In view of perceived poor ...

  17. Treating natural disaster victims is dealing with shortages: An orthopaedics perspective.

    NARCIS (Netherlands)

    Dewo, Punto; Magetsari, Rahadyan; Busscher, Henk J.; van Horn, Jim R.; Verkerke, Gijsbertus Jacob


    During natural disasters such as earthquakes or tsunamis, most of the casualties are known to suffer from musculoskeletal injuries. This leads to an enormous need of orthopaedic (surgical) implants such as osteosynthesis plates, which are difficult to provide in developing countries that rely on

  18. The attitude of final year medical students to orthopaedics in a ...

    African Journals Online (AJOL)

    Aim: To determine the attitude of final year medical students to the clinical posting and lectures in Orthopaedics and to find out the improvements they desire to make it more interesting. Material/Methods: A descriptive, cross sectional study was carried out among one hundred and eighty two final year medical students of the ...

  19. Biodegradable magnesium alloys for orthopaedic applications: A review on corrosion, biocompatibility and surface modifications. (United States)

    Agarwal, Sankalp; Curtin, James; Duffy, Brendan; Jaiswal, Swarna


    Magnesium (Mg) and its alloys have been extensively explored as potential biodegradable implant materials for orthopaedic applications (e.g. Fracture fixation). However, the rapid corrosion of Mg based alloys in physiological conditions has delayed their introduction for therapeutic applications to date. The present review focuses on corrosion, biocompatibility and surface modifications of biodegradable Mg alloys for orthopaedic applications. Initially, the corrosion behaviour of Mg alloys and the effect of alloying elements on corrosion and biocompatibility is discussed. Furthermore, the influence of polymeric deposit coatings, namely sol-gel, synthetic aliphatic polyesters and natural polymers on corrosion and biological performance of Mg and its alloy for orthopaedic applications are presented. It was found that inclusion of alloying elements such as Al, Mn, Ca, Zn and rare earth elements provides improved corrosion resistance to Mg alloys. It has been also observed that sol-gel and synthetic aliphatic polyesters based coatings exhibit improved corrosion resistance as compared to natural polymers, which has higher biocompatibility due to their biomimetic nature. It is concluded that, surface modification is a promising approach to improve the performance of Mg-based biomaterials for orthopaedic applications. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Bacteria Antibiotic Resistance: New Challenges and Opportunities for Implant-Associated Orthopaedic Infections (United States)

    Li, Bingyun; Webster, Thomas J.


    There has been a dramatic increase in the emergence of antibiotic resistant bacterial strains, which has made antibiotic choices for infection control increasingly limited and more expensive. In the U.S. alone, antibiotic resistant bacteria cause at least 2 million infections and 23,000 deaths a year resulting in a $55–70 billion per year economic impact. Antibiotics are critical to the success of surgical procedures including orthopaedic prosthetic surgeries, and antibiotic resistance is occurring in nearly all bacteria that infect people, including the most common bacteria that cause orthopaedic infections, such as Staphylococcus aureus (S. aureus). Most clinical cases of orthopaedic surgeries have shown that patients infected with antibiotic resistant bacteria, such as methicillin resistant S. aureus (MRSA), are associated with increased morbidity and mortality. This paper reviews the severity of antibiotic resistance at the global scale, the consequences of antibiotic resistance, and the pathways bacteria used to develop antibiotic resistance. It highlights the opportunities and challenges in limiting antibiotic resistance through approaches like the development of novel, non-drug approaches to reduce bacteria functions related to orthopaedic implant-associated infections. PMID:28722231

  1. Antibiotic prophylaxis for dental treatment after prosthetic joint replacement: exploring the orthopaedic surgeon's opinion

    Directory of Open Access Journals (Sweden)

    Clare M. McNally, MPhil(Dent


    Conclusions: Australian orthopaedic surgeons continue to recommend antibiotic prophylaxis for dental treatment. The recording of PJI in relation to dental procedures into clinical registries would enable the development of consistent guidelines between professional groups responsible for the care of this patient group.

  2. Burnout in Orthopaedic Surgeons: A Challenge for Leaders, Learners, and Colleagues: AOA Critical Issues. (United States)

    Ames, S Elizabeth; Cowan, James B; Kenter, Keith; Emery, Sanford; Halsey, David


    Burnout, depression, suicidal ideation, and dissatisfaction with work-life balance have been reported in all medical specialties and at all stages of medical education and practice experience. Burnout consists of progressive emotional, attitudinal, and physical exhaustion. Physicians with burnout may treat patients as objects and feel emotionally depleted. Burnout is characterized by a loss of enthusiasm for work (emotional exhaustion), feelings of cynicism (depersonalization), and a low sense of personal accomplishment. The most complete study of emotional burnout among different medical specialties demonstrated that orthopaedic surgery is one of the specialties with the highest burnout rate. Qualitative descriptive studies are available. There was a 45.8% burnout rate among physicians in the U.S. in 2012, and a 2014 update suggested even higher rates. Burnout has a correlation with medical education. Burnout rates are similar to those in the general population when medical students enter school, and increase steadily through medical education prior to residency. Burnout rates in residents are high, reported to be between 41% and 74% across multiple specialties. This impacts our young physician workforce in orthopaedics. The purpose of this review is to provide the available information that characterizes burnout and addresses the issues inherent to preventing burnout, and to build awareness in orthopaedic surgeons. Wellness "goes beyond merely the absence of distress and includes being challenged, thriving, and achieving success in various aspects of personal and professional life." The challenge for the orthopaedic community is to develop interventions and strategies that are personalized to the individuals in this specialty.

  3. 78 FR 66942 - Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee; Notice of... (United States)


    ... between the vertebral bodies into the disc space from L3-S1 to help provide stabilization and to help.... This notice announces a forthcoming meeting of a public advisory committee of the Food and Drug Administration (FDA). The meeting will be open to the public. Name of Committee: Orthopaedic and Rehabilitation...

  4. Does Change in Functional Performance Affect Quality of Life in Persons with Orthopaedic Impairment? (United States)

    Ostir, Glenn V.; Berges, Ivonne-Marie; Smith, Pamela M.; Smith, David; Rice, Janida L.; Ottenbacher, Kenneth J.


    Background and Purpose: Examine the association between change in functional status and quality of life for individuals with orthopaedic impairments approximately 90 days after discharge from in-patient medical rehabilitation. Methods: A retrospective study from 2001 to 2002 using information from the IT HealthTrack database. The study included…

  5. Should probenecid be used to reduce the dicloxacillin dosage in orthopaedic infections?

    DEFF Research Database (Denmark)

    Krogsgaard, M R; Hansen, B A; Slotsbjerg, T


    Reduction in the dosage of dicloxacillin from 500 mg to 250 mg 3 times a day would mean lowering of costs and less side-effects in orthopaedic infections. In this cross-over study, the serum concentrations of dicloxacillin were measured in 9 patients after administration of dicloxacillin 500 mg 3...

  6. Titanium-Nitride Coating of Orthopaedic Implants: A Review of the Literature

    NARCIS (Netherlands)

    van Hove, R.P.; Sierevelt, I.N.; van Royen, B.J.; Nolte, P.A.


    Surfaces of medical implants can be enhanced with the favorable properties of titanium-nitride (TiN). In a review of English medical literature, the effects of TiN-coating on orthopaedic implant material in preclinical studies were identified and the influence of these effects on the clinical

  7. Decellularized Tissue and Cell-Derived Extracellular Matrices as Scaffolds for Orthopaedic Tissue Engineering (United States)

    Cheng, Christina W.; Solorio, Loran D.; Alsberg, Eben


    The reconstruction of musculoskeletal defects is a constant challenge for orthopaedic surgeons. Musculoskeletal injuries such as fractures, chondral lesions, infections and tumor debulking can often lead to large tissue voids requiring reconstruction with tissue grafts. Autografts are currently the gold standard in orthopaedic tissue reconstruction; however, there is a limit to the amount of tissue that can be harvested before compromising the donor site. Tissue engineering strategies using allogeneic or xenogeneic decellularized bone, cartilage, skeletal muscle, tendon and ligament have emerged as promising potential alternative treatment. The extracellular matrix provides a natural scaffold for cell attachment, proliferation and differentiation. Decellularization of in vitro cell-derived matrices can also enable the generation of autologous constructs from tissue specific cells or progenitor cells. Although decellularized bone tissue is widely used clinically in orthopaedic applications, the exciting potential of decellularized cartilage, skeletal muscle, tendon and ligament cell-derived matrices has only recently begun to be explored for ultimate translation to the orthopaedic clinic. PMID:24417915

  8. Tracing Crop Nitrogen Dynamics on the Field-Scale by Combining Multisensoral EO Data with an Integrated Process Model- A Validation Experiment for Cereals in Southern Germany (United States)

    Hank, Tobias B.; Bach, Heike; Danner, Martin; Hodrius, Martina; Mauser, Wolfram


    Nitrogen, being the basic element for the construction of plant proteins and pigments, is one of the most important production factors for agricultural cultivation. High resolution and near real-time information on nitrogen status in the soil thus is of highest interest for economically and ecologically optimized fertilizer planning and application. Unfortunately, nitrogen storage in the soil column cannot be directly observed with Earth Observation (EO) instruments. Advanced EO supported process modelling approaches therefore must be applied that allow tracing the spatiotemporal dynamics of nitrogen transformation, translocation and transport in the soil and in the canopy. Before these models can be applied as decision support tools for smart farming, they must be carefully parameterized and validated. This study applies an advanced land surface process model (PROMET) to selected winter cereal fields in Southern Germany and correlates the model outputs to destructively sampled nitrogen data from the growing season of 2015 (17 sampling dates, 8 sample locations). The spatial parametrization of the process model thereby is supported by assimilating eight satellite images (5 times Landsat 8 OLI and 3 times RapidEye). It was found that the model is capable of realistically tracing the temporal and spatial dynamics of aboveground nitrogen uptake and allocation (R2 = 0.84, RMSE 31.3 kg ha-1).

  9. Orthopaedic Sports Medicine Fellowship Interviews: Structure and Organization of the Interview Day. (United States)

    Haislup, Brett D; Kraeutler, Matthew J; Baweja, Rishi; McCarty, Eric C; Mulcahey, Mary K


    Over the past few decades, there has been a trend toward an increasing subspecialization in orthopaedic surgery, with orthopaedic sports medicine being one of the most competitive subspecialties. Information regarding the application and interview process for sports medicine fellowships is currently lacking. To survey orthopaedic sports medicine fellowship program directors (PDs) to better define the structure of the sports medicine fellowship interview and to highlight important factors that PDs consider in selecting fellows. Cross-sectional study. A complete list of accredited programs was obtained from the American Orthopaedic Society for Sports Medicine (AOSSM) website. An anonymous survey was distributed to fellowship PDs of all Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic sports medicine fellowships in the United States. The survey included 12 questions about the fellowship interview and selection process. Of the 95 orthopaedic sports medicine fellowship PDs surveyed, 38 (40%) responded. Of these, 16 (42.1%) indicated that they interview between 21 and 30 applicants per year. Eleven of the 38 fellowship programs (28.9%) have only 1 fellow per year at their respective program. Most programs (27/37, 73%) reported that between 0 and 5 faculty members interview applicants, and 29 of the 38 programs (76.3%) arrange for applicants to have ≥4 interviews during their interview day. Large group interviews are conducted at 36 of 38 (94.7%) sports medicine fellowship programs, and most programs (24/38, 63.2%) hold individual interviews that last between 5 and 15 minutes. The most important applicant criterion taken into account by PDs was the quality of the interview, with an average score of 8.68 of 10. The most significant factor taken into account by PDs when deciding how to rank applicants was the quality of the interview. Many orthopaedic sports medicine fellowship programs interview between 21 and 30 applicants per year

  10. Determining the Most Important Factors Involved in Ranking Orthopaedic Sports Medicine Fellowship Applicants. (United States)

    Baweja, Rishi; Kraeutler, Matthew J; Mulcahey, Mary K; McCarty, Eric C


    Orthopaedic surgery residencies and certain fellowships are becoming increasingly competitive. Several studies have identified important factors to be taken into account when selecting medical students for residency interviews. Similar information for selecting orthopaedic sports medicine fellows does not exist. To determine the most important factors that orthopaedic sports medicine fellowship program directors (PDs) take into account when ranking applicants. Cross-sectional study. A brief survey was distributed electronically to PDs of the 92 orthopaedic sports medicine fellowship programs that are accredited by the Accreditation Council for Graduate Medical Education (ACGME). Each PD was asked to rank, in order, the 5 most important factors taken into account when ranking applicants based on a total list of 13 factors: the interview, the applicant's residency program, letters of recommendation (LORs), personal connections made through the applicant, research experience, an applicant's geographical ties to the city/town of the fellowship program, United States Medical Licensing Examination (USMLE) scores, Orthopaedic In-Training Examination (OITE) scores, history of being a competitive athlete in college, extracurricular activities/hobbies, volunteer experience, interest in a career in academics, and publications/research/posters. Factors were scored from 1 to 5, with a score of 5 representing the most important factor and 1 representing the fifth-most important factor. Of the 92 PDs contacted, 57 (62%) responded. Thirty-four PDs (37%) listed the interview as the most important factor in ranking fellowship applicants (overall score, 233). LORs (overall score, 196), an applicant's residency program (overall score, 133), publications/research/posters (overall score, 115), and personal connections (overall score, 90) were reported as the second- through fifth-most important factors, respectively. According to orthopaedic sports medicine fellowship PDs, the

  11. How does the knowledge environment shape procurement practices for orthopaedic medical devices in Mexico? (United States)

    Lingg, Myriam; Wyss, Kaspar; Durán-Arenas, Luis


    In organisational theory there is an assumption that knowledge is used effectively in healthcare systems that perform well. Actors in healthcare systems focus on managing knowledge of clinical processes like, for example, clinical decision-making to improve patient care. We know little about connecting that knowledge to administrative processes like high-risk medical device procurement. We analysed knowledge-related factors that influence procurement and clinical procedures for orthopaedic medical devices in Mexico. We based our qualitative study on 48 semi-structured interviews with various stakeholders in Mexico: orthopaedic specialists, government officials, and social security system managers or administrators. We took a knowledge-management related perspective (i) to analyse factors of managing knowledge of clinical procedures, (ii) to assess the role of this knowledge and in relation to procurement of orthopaedic medical devices, and (iii) to determine how to improve the situation. The results of this study are primarily relevant for Mexico but may also give impulsion to other health systems with highly standardized procurement practices. We found that knowledge of clinical procedures in orthopaedics is generated inconsistently and not always efficiently managed. Its support for procuring orthopaedic medical devices is insufficient. Identified deficiencies: leaders who lack guidance and direction and thus use knowledge poorly; failure to share knowledge; insufficiently defined formal structures and processes for collecting information and making it available to actors of health system; lack of strategies to benefit from synergies created by information and knowledge exchange. Many factors are related directly or indirectly to technological aspects, which are insufficiently developed. The content of this manuscript is novel as it analyses knowledge-related factors that influence procurement of orthopaedic medical devices in Mexico. Based on our results we

  12. The experiences of orthopaedic and trauma nurses who have cared for adults with a learning disability. (United States)

    Drozd, Mary; Clinch, Christine


    There is no published empirical research about the experiences of orthopaedic and trauma nurses who have cared for people with a learning disability. However, adults with a learning disability sustain more injuries, falls and accidents than the general population. Because of their increased health needs, there has been a corresponding increase in their numbers attending general/acute hospitals. The 6 Cs is a contemporary framework and has been used to gauge how orthopaedic and trauma nurses rate the Care, Communication, Competence, Commitment, Courage and Compassion for patients with a learning disability in orthopaedic and trauma hospital settings compared to patients without a learning disability. The aim of the study was to explore the experiences of orthopaedic and trauma nurses who have cared for people with a learning disability. The study is based on a descriptive survey design and used a questionnaire to elicit data from participants. A convenience sample of Registered Nurses completed a questionnaire. The study was explained to delegates attending a concurrent session on the topic of acute hospital care for people with a learning disability at a conference and the questionnaire was left on a table for participants to take if they wished. Questionnaires were returned anonymously. Of the participants who had completed the questionnaire 100% (n = 13) had cared for a patient with a learning disability. Using the 6 Cs as a framework suggested that care, communication and competence of nurses were worse for people with a learning disability than for people without a learning disability. Three main themes emerged regarding areas of good practices: (1) promoting a positive partnership with patients and carers; (2) modifying care and interventions; (3) supporting the healthcare team. There was evidence of good practices within orthopaedic and trauma settings such as the active involvement of family or a paid carer who is known to thepatient and the modification

  13. The Development of Two Science Investigator-led Processing Systems (SIPS) for NASA's Earth Observation System (EOS) (United States)

    Tilmes, Curt


    In 2001, NASA Goddard Space Flight Center's Laboratory for Terrestrial Physics started the construction of a science Investigator-led Processing System (SIPS) for processing data from the Ozone Monitoring Instrument (OMI) which will launch on the Aura platform in mid 2004. The Ozone Monitoring Instrument (OMI) is a contribution of the Netherlands Agency for Aerospace Programs (NIVR) in collaboration with the Finnish Meteorological Institute (FMI) to the Earth Observing System (EOS) Aura mission. It will continue the Total Ozone Monitoring System (TOMS) record for total ozone and other atmospheric parameters related to ozone chemistry and climate. OMI measurements will be highly synergistic with the other instruments on the EOS Aura platform. The LTP previously developed the Moderate Resolution Imaging Spectrometer (MODIS) Data Processing System (MODAPS), which has been in full operations since the launches of the Terra and Aqua spacecrafts in December, 1999 and May, 2002 respectively. During that time, it has continually evolved to better support the needs of the MODIS team. We now run multiple instances of the system managing faster than real time reprocessings of the data as well as continuing forward processing. The new OMI Data Processing System (OMIDAPS) was adapted from the MODAPS. It will ingest raw data from the satellite ground station and process it to produce calibrated, geolocated higher level data products. These data products will be transmitted to the Goddard Distributed Active Archive Center (GDAAC) instance of the Earth Observing System (EOS) Data and Information System (EOSDIS) for long term archive and distribution to the public. The OMIDAPS will also provide data distribution to the OMI Science Team for quality assessment, algorithm improvement, calibration, etc. We have taken advantage of lessons learned from the MODIS experience and software already developed for MODIS. We made some changes in the hardware system organization, database and

  14. Earth Observing System (EOS)/ Advanced Microwave Sounding Unit-A (AMSU-A): Special Test Equipment. Software Requirements (United States)

    Schwantje, Robert


    This document defines the functional, performance, and interface requirements for the Earth Observing System/Advanced Microwave Sounding Unit-A (EOS/AMSU-A) Special Test Equipment (STE) software used in the test and integration of the instruments.

  15. Berkeley Lab's Saul Perlmutter wins E.O. Lawrence Award; scientist's work on supernovae reveals accelerating Universe

    CERN Multimedia


    Saul Perlmutter, from Lawrence Berkeley National Laboratory Physics Division and leader of the Supernova Cosmology Project based there, has won the DOE's 2002 E.O. Lawrence Award in the physics category (2 pages).

  16. The Libyan civil conflict: selected case series of orthopaedic trauma managed in Malta in 2014. (United States)

    Ng, Colin; Mifsud, Max; Borg, Joseph N; Mizzi, Colin


    The purpose of this series of cases was to analyse our management of orthopaedic trauma casualties in the Libyan civil war crisis in the European summer of 2014. We looked at both damage control orthopaedics and for case variety of war trauma at a civilian hospital. Due to our geographical proximity to Libya, Malta was the closest European tertiary referral centre. Having only one Level 1 trauma care hospital in our country, our Trauma and Orthopaedics department played a pivotal role in the management of Libyan battlefield injuries. Our aims were to assess acute outcomes and short term mortality of surgery within the perspective of a damage control orthopaedic strategy whereby aggressive wound management, early fixation using relative stability principles, antibiotic cover with adequate soft tissue cover are paramount. We also aim to describe the variety of war injuries we came across, with a goal for future improvement in regards to service providing. Prospective collection of six interesting cases with severe limb and spinal injuries sustained in Libya during the Libyan civil war between June and November 2014. We applied current trends in the treatment of war injuries, specifically in damage control orthopaedic strategy and converting to definitive treatment where permissible. The majority of our cases were classified as most severe (Type IIIB/C) according to the Gustilo-Anderson classification of open fractures. The injuries treated reflected the type of standard and improved weaponry available in modern warfare affecting both militants and civilians alike with increasing severity and extent of damage. Due to this fact, multidisciplinary team approach to patient centred care was utilised with an ultimate aim of swift recovery and early mobilisation. It also highlighted the difficulties and complex issues required on a hospital management level as a neighbouring country to war zone countries in transforming care of civil trauma to military trauma.

  17. Staphylococcus aureus screening and decolonization in orthopaedic surgery and reduction of surgical site infections. (United States)

    Chen, Antonia F; Wessel, Charles B; Rao, Nalini


    Staphylococcus aureus is the most common organism responsible for orthopaedic surgical site infections (SSIs). Patients who are carriers for methicillin-sensitive S. aureus or methicillin-resistant S. aureus (MRSA) have a higher likelihood of having invasive S. aureus infections. Although some have advocated screening for S. aureus and decolonizing it is unclear whether these efforts reduce SSIs. The purposes of this study were to determine (1) whether S. aureus screening and decolonization reduce SSIs in orthopaedic patients and (2) if implementing this protocol is cost-effective. Studies for this systematic review were identified by searching PubMed, which includes MEDLINE (1946-present), (1974-present), and the Cochrane Library's (John Wiley & Sons) Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database (HTAD), and the NHS Economic Evaluation Database (NHSEED). Comprehensive literature searches were developed using EMTREE, MeSH, and keywords for each of the search concepts of decolonization, MRSA, and orthopedics/orthopedic surgery. Studies published before 1968 were excluded. We analyzed 19 studies examining the ability of the decolonization protocol to reduce SSIs and 10 studies detailing the cost-effectiveness of S. aureus screening and decolonization. All 19 studies showed a reduction in SSIs or wound complications by instituting a S. aureus screening and decolonization protocol in elective orthopaedic (total joints, spine, and sports) and trauma patients. The S. aureus screening and decolonization protocol also saved costs in orthopaedic patients when comparing the costs of screening and decolonization with the reduction of SSIs. Preoperative screening and decolonization of S. aureus in orthopaedic patients is a cost-effective means to reduce SSIs. Level IV, systematic review of Level I-IV studies. See the

  18. Workers' compensation status: does it affect orthopaedic surgery outcomes? A meta-analysis.

    Directory of Open Access Journals (Sweden)

    Vinícius Ynoe de Moraes

    Full Text Available INTRODUCTION: Previous reviews have demonstrated that patient outcomes following orthopaedic surgery are strongly influenced by the presence of Workers' Compensation. However, the variability in the reviews' methodology may have inflated the estimated strength of this association. The main objective of this meta-analysis is to evaluate the influence of Workers' Compensation on the outcomes of orthopaedic surgical procedures. METHODS: We conducted a systematic search of the literature published in this area from 1992-2012, with no language restrictions. The following databases were used MEDLINE (Ovid, Embase (Ovid, CINAHL, Google Scholar, LILACS and Pubmed. We also hand-searched the reference sections of all selected papers. We included all prospective studies evaluating the effect of compensation status on outcomes in adult patients who had undergone surgery due to orthopaedic conditions or diseases. Outcomes of interest included disease specific, region specific and/or overall quality of life scales/questionnaires and surgeons' personal judgment of the results. We used an assessment tool to appraise the quality of all included studies. We used Review Manager to create forest plots to summarize study data and funnel plots for the assessment of publication bias. RESULTS: Twenty studies met our eligibility criteria. The overall risk ratio for experiencing an unsatisfactory result after orthopaedic surgery for patients with compensation compared to non-compensated patients is 2.08 (95% CI 1.54-2.82. A similar association was shown for continuous data extracted from the studies using assessment scales or questionnaires (Standard Mean Difference = -0.70 95% CI -0.97- -0.43. CONCLUSIONS: Among patients who undergo orthopaedic surgical procedures, those receiving Workers' Compensation experience a two-fold greater risk of a negative outcome. Our findings show a considerably lower estimate of risk compared to previous reviews that include retrospective

  19. Micellization Thermodynamics of Pluronic P123 (EO20PO70EO20 Amphiphilic Block Copolymer in Aqueous Ethylammonium Nitrate (EAN Solutions

    Directory of Open Access Journals (Sweden)

    Zhiqi He


    Full Text Available Poly(ethylene oxide-poly(propylene oxide-poly(ethylene oxide (PEO-PPO-PEO block copolymers (commercially available as Pluronics or Poloxamers can self-assemble into various nanostructures in water and its mixtures with polar organic solvents. Ethylammonium nitrate (EAN is a well-known protic ionic liquid that is expected to affect amphiphile self-assembly due to its ionic nature and hydrogen bonding ability. By proper design of isothermal titration calorimetry (ITC experiments, we determined the enthalpy and other thermodynamic parameters of Pluronic P123 (EO20PO70EO20 micellization in aqueous solution at varied EAN concentration. Addition of EAN promoted micellization in a manner similar to increasing temperature, e.g., the addition of 1.75 M EAN lowered the critical micelle concentration (CMC to the same extent as a temperature increase from 20 to 24 °C. The presence of EAN disrupts the water solvation around the PEO-PPO-PEO molecules through electrostatic interactions and hydrogen bonding, which dehydrate PEO and promote micellization. At EAN concentrations lower than 1 M, the PEO-PPO-PEO micellization enthalpy and entropy increase with EAN concentration, while both decrease above 1 M EAN. Such a change can be attributed to the formation by EAN of semi-ordered nano-domains with water at higher EAN concentrations. Pyrene fluorescence suggests that the polarity of the mixed solvent decreased linearly with EAN addition, whereas the polarity of the micelle core remained unaltered. This work contributes to assessing intermolecular interactions in ionic liquid + polymer solutions, which are relevant to a number of applications, e.g., drug delivery, membrane separations, polymer electrolytes, biomass processing and nanomaterial synthesis.

  20. Images. (United States)

    Barr, Catherine, Ed.


    The theme of this month's issue is "Images"--from early paintings and statuary to computer-generated design. Resources on the theme include Web sites, CD-ROMs and software, videos, books, and others. A page of reproducible activities is also provided. Features include photojournalism, inspirational Web sites, art history, pop art, and myths. (AEF)